Please click the “View Form” button below to view the <|title|> form.
Electronic Signature Consent. You agree that this agreement may be electronically signed and that any digital or electronic signatures (including pdf, facsimile or electronically imaged signatures, electronically printed name input in an online form as a signature input, or any digital signature provider mechanism) appearing on this agreement is the same as handwritten signatures for the purposes of validity, enforceability and admissibility, and that delivery of any such electronic signature to, or a signed copy of, this agreement and such other documents may be made by facsimile, email or other electronic transmissions.
Confirmation of Identity. You agree that the information provided to us is true and correct, including information regarding your identity, such as your legal name, known business or residence address, email address, telephone number, and any other information of a personally identifying nature. You agree your given email address may be used to transmit an electronic copy of the signed agreement which shall be valid as an original copy of the agreement. The failure to open, download or save a copy of the e-signed agreement that is sent to your email address does not invalidate the agreement.
Please enter your full name below to acknowledge that you have read, understand, and accept the <|title|>:
When you click the below Sign button, the names from the boxes above will be recorded as digital signatures, and the completed agreement will be emailed to the address associated with your account.