DPA Agreement Form

What’s the name of your company?*
What's your Jotform username?*
What’s your company address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What’s your full name?*

First NameLast Name
What’s your email address?*
We’ll never use this email for marketing purposes.
What’s your role at this company?*
In which language, do you prefer to get your agreement?

EnglishGerman
Are you authorized to sign on behalf of this company?*

Yes, I'm authorized to sign on behalf of this company.
Authorized signature*

Clear
Jotform Entity*

USUK
Should be Empty: