Security Camera Notice Sign Acknowledgment Form
Please complete this form to confirm you have seen and understood the security camera notice sign at the specified location.
Full Name
*
First Name
Last Name
Role
*
Please Select
Visitor
Tenant
Staff
Contractor
Other
Organization/Unit (if applicable)
Contact Email or Phone (optional)
Location of Notice Sign
*
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of Acknowledgment
*
Hour Minutes
AM
PM
AM/PM Option
Did you clearly see the security camera notice sign?
*
Yes
No
Do you understand that the area is monitored by security cameras as indicated by the notice?
*
Yes
No
Submit Acknowledgment
Should be Empty: