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National Association of GSA Networks Database Individual User Access Agreement

As a member of the National Association of GSA Networks, GSA Network provides access to up to three (3) staff/board members to state-wide GSA Club Registrations. Access should only be given to staff/board who have an organizational need to access the contact information of those groups registering in their state.

By signing this form, I agree to adhere to privacy policies concerning the contacts and other information found in and from the GSA Registry database, for which I will be granted access. No contact information found in or from the GSA Registry database can be traded, sold, or provided to third parties. I also agree to never expose Personally identifiable information or PII.

Personally identifiable information is any data that could potentially be used to identify a particular person. Examples include but are not limited to: full name, legal name, date of birth, demographic information, email/physical address, and phone number.

I agree to never share my login information and that doing so would result in revocation of my access and potentially that of my organization.

This agreement will last one year, and must be re-signed each year to ensure that we have the correct information for each user as well as maintain the security and integrity of our database.

Any changes to my employment or position within the organization I have listed may result in loss of access to the database. To ensure a lasting agreement between our organizations, I understand that if I leave my position, for any reason, I will lose access to the database.

I understand that I must participate in a training prior to receiving database access.

Name:

Organization Name:

Work Email:

Role/Title:

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Your legal name

Your email address

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July 24, 2020 10:22 am PDT

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July 15, 2021 3:34 pm PDT

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