Defined Categories of Service 2011

First Name

Last Name

Phone

Email

Organization Name

Title at Organization

Address

Address cont.

City

State

Country

Zip / Postal Code

Having read and understood the CSA’s Privacy Policy,

I object to the processing of my Personal Data for Soft Opt-In Marketing purposes, as defined in Section 3 of the Privacy Policy.

I consent to the processing of my Personal Data for Marketing purposes, as defined in Section 3 of the Privacy Policy.

I consent to the processing of my Personal Data for Profiling purposes, as defined in Section 3 of the Privacy Policy.

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