Government Agency (Federal, State & Local), Military and Government Training Organization
Contact Form
Government Agency, Military or Training Organization
*
Contact Name
*
First Name
Last Name
Title
*
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Authority to enter into agreement
*
I am over 18 years old and have full legal authority to enter into this agreement and make purchases on behalf of the Government Agency listed above.
Agency Acceptance
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I further certify that I have completely read the foregoing and I on behalf of my Government agency agree to all of the provisions of this agreement and the related rules attached hereto. I, under penalty of perjury, hereby affirm to the above stated terms of this agreement.
Name person signing Agency Agreement
*
First Name
Last Name
Legal Signature of person listed above
*
Date signed
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