Fill and Sign the Electronic Signature Form

Electronic Signature Agreement By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual or handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and       . You are also (Name of Other Party) confirming that you are the person authorized to enter into this Agreement. You further agree that each use of your email equates to your E-Signature and constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form. Consent to Electronic Delivery. By selecting the “I Accept” button, you specifically agree to receive, obtain, and/or submit any and all documents and information electronically. These documents and information will be collectively known as "Electronic Communications," and will include, but not be limited to,       . (Describe) You are acknowledging that you are able to use your email and are able to retain Electronic Communications by printing and/or downloading and saving this Agreement and any other agreements, Electronic Communications, documents, or records that are signed using your E- Signature. You accept Electronic Communications provided via email as reasonable and proper notice for the purpose of fulfilling any and all rules and regulations, and agree that such Electronic Communications fully satisfy any requirement that communications be provided to you in writing or in a form that you may keep. Definitions Electronic means technology having electrical, digital, magnetic, wireless, optical, electromagnetic, or similar capabilities. Electronic Signature means an electronic symbol or process attached to, or logically associated with, a record and used by a person with the intent to sign the record. System means a data processing or student information system used to create, store, sign, retrieve and/or manage the documents or records that constitute the student file. System Rules mean rules that apply to all participants using a particular system. For example, such rules might cover issues relating to access rights, distribution of system risk, sending and receiving electronic documents, intellectual property rights, and remedies for breach of system rules. Paper version of Electronic Communications: You acknowledge and agree that you may request a paper version of the verification worksheet or other documents by       Electronic Signature Agreement Page 1 of 3       . (Method) Revocation of electronic delivery: You have the right to withdraw your consent to submit communications via email at any time. You acknowledge that you are aware this action may delay the transaction to which this Electronic Signature relates. If you wish to withdraw your consent, you will       . (Method of Withdrawal) Valid email address and use of email system: Your current valid email address is required for you to receive communication from       . It is your (Name) responsibility to check your email regularly for Electronic Communications and updates. You will be deemed to have received an electronic communication when the communication is sent to you. Hardware, software and operating system : You are responsible for installation, maintenance, and operation of your computer, browser and software. Your e-mail provider is not responsible for errors or failures due to any malfunction of your computer, browser or software. Your e-mail provider is also not responsible for computer viruses or related problems associated with use of an online system. Your signature indicates that you have access to the Internet, an email account capable of receiving communication from the       . You (Name of Other Party) must also have the necessary minimum hardware, software, and operating systems, as well as access to one of the following web browsers capable of supporting 128-bit, SSL encrypted communications:  Internet Explorer version 7.0 or higher;  Firefox version 3.0 or higher;  Chrome 14.0 or higher; and  Safari 5.0 or higher. Violations: It is a violation of this provision for an individual to sign/e-sign a transaction on behalf of another individual, unless he or she has been granted specific, written and legal authority to do so by that individual or by a court of competent jurisdiction. Individuals shall report any suspected fraudulent activities related to electronic signatures immediately to       . Falsifying electronic signatures or (Name) otherwise violating this regulation is subject to disciplinary action and criminal prosecution under applicable Federal and State laws. By electronically signing below we recommend that you print a copy of this Agreement for future reference. At the end of this document, you will be asked to provide an electronic signature. Please keep all records relating to this Agreement and print or make an electronic copy of the Terms and Conditions. I understand and agree to each and all of the Terms and Conditions in this Electronic Signature Agreement Page 2 of 3 Agreement. My electronic signature is legally binding. Please check the appropriate box and provide your signature. I Accept I Decline Because of the nature of federal, state, and institutional guidelines the information contained in this website is subject to change. The information and external links on this site are provided by       as a service to our users. In no event shall we be (Name) responsible or liable, directly or indirectly, for any damage or loss caused or alleged to be caused by or in connection with the use of or reliance on any such content, goods, or services available on or through any such site or resource Electronic Signature Agreement Page 3 of 3