Mobile Device Use Policy Acknowledgment
Please complete this form to acknowledge receipt and understanding of your organization's mobile device use policy.
Employee Full Name
*
First Name
Last Name
Employee ID Number
*
Department
*
Supervisor Name
First Name
Last Name
Employee Email Address
*
example@example.com
Device Type
*
Please Select
Smartphone
Tablet
Laptop
Other
Device Make and Model
*
Device Serial Number
*
Date of Device Assignment
*
-
Month
-
Day
Year
Date
Intended Business Use
I acknowledge receipt of the above device and understand I am responsible for its care and use according to company policy.
*
I agree and acknowledge
Upload a photo of the device (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Comments or Special Instructions
Signature (please sign to confirm your agreement and understanding)
*
Submit Policy Acknowledgment
Submit Policy Acknowledgment
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