PRIVACY CONSENT FORM

[Organization/Company Name]

By signing below, I acknowledge and agree to the following:

1. Information Collected
I understand that [Organization Name] will collect the following personal information: [e.g., name, email address, phone number, date of birth, photos, etc.]

2. Purpose of Collection
This information will be used for: [e.g., account registration, service delivery, communication, marketing purposes, research, etc.]

3. How Information Will Be Used

To provide the requested service/product
To communicate updates or important information
For marketing and promotional purposes
For research or analytical purposes
Other: ___________________

4. Data Sharing
I understand that my information [will / will not] be shared with third parties, specifically: [list any third parties, or state “none”]

5. Data Storage & Security
My data will be stored securely and retained for [duration, e.g., “the duration of my account” or “5 years”], after which it will be [deleted/anonymized].

6. My Rights
I understand that I have the right to:

Access my personal data
Request corrections
Withdraw consent at any time
Request deletion of my data (where applicable)