Cybersecurity Handbook Acknowledgement Form
Please complete this form to confirm you received, reviewed, and understand the cybersecurity handbook and the responsibilities it contains.
Employee Information
Full Name
*
First Name
Middle Name
Last Name
Department / Team
*
Please Select
Engineering
IT Security
Human Resources
Operations
Finance
Sales
Marketing
Legal
Other
Job Title
*
Work Email
*
example@example.com
Handbook Receipt and Review
Handbook Version or Document Name
*
Date Received or Acknowledged
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Handbook Received and Reviewed?
*
Yes, I received and reviewed it
No, I have not reviewed it yet
Cybersecurity Responsibilities Acknowledgement
I understand and will follow password hygiene requirements
*
Yes
No
I understand how to recognize and report phishing or suspicious emails
*
Yes
No
I will secure my device and workstation in accordance with company requirements
*
Yes
No
I acknowledge the rules for approved software use and data handling
*
Approved software only
Store and share data only through approved systems
Use company-approved devices for work tasks
Other
Questions or topics needing clarification
Manager and Follow-Up
Manager/Supervisor Name
*
First Name
Last Name
Additional Training or Follow-Up Questions
Acknowledgment Signature
*
Acknowledgment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Acknowledgement
Submit Acknowledgement
Should be Empty: