Software Usage Disclaimer Acknowledgement Form
Please review the disclaimer and acknowledge your understanding before accessing the software.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Organization or Company Name
*
Department or Team
Software Name
*
Software Version (if applicable)
Intended Use of the Software
*
Device or Platform (e.g., Windows, Mac, Mobile)
*
Please Select
Windows
MacOS
Linux
iOS
Android
Web Browser
Other
Location of Use (e.g., Office, Remote, Home)
*
Please Select
Office
Remote
Home
Other
Date of Acknowledgement
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature (Please sign below to confirm your acknowledgement)
*
Additional Comments or Questions (optional)
Acknowledge and Submit
Acknowledge and Submit
Should be Empty: