Client Application "*" indicates required fields Legal Organization*Doing Business As (DBA)Business Address* Street Address Address Line 2 City State/Province ZIP/Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Contact Name*Primary Contact Role*Owner/PartnerCEO/President/Managing DirectorVice President/General ManagerHuman Resources ManagerCompliance OfficerPrimary Contact Email* Preferred Phone*Is this a Mobile?* Yes No Are texts welcome?* Yes No Alternate Phone*Is this a Mobile?* Yes No Are texts welcome?* Yes No Secondary Contact Name*Secondary Contact Role*Owner/PartnerCEO/President/Managing DirectorVice President/General ManagerHuman Resources ManagerCompliance OfficerI am applying on behalf of a…* Service Provider/Data Processor Covered Entity/Data Controller Individual/Data Subject Legal Professional Supplier/Manufacturer/Developer Data Processor Client ApplicationData Processor Services of Interest* Content Development/Ghostwriting Client-facing Events & Consultations Policy Development Required Periodic Policy Review Employee Compliance Training (Virtual or Onsite) RFP/RFQ Response/Submission Counseling Business Plan Creation/Evaluation/Support Marketing Projects & Research Subcontractor Identification/Vetting/Relationship Management Bid Protests Expert Witness Professional Liability Insurance Review/Advocacy * Contract Review/Advocacy ** Referring Privata Vox to a Client/Data Controller Exclusive Representation Other Privata Vox Services (Please describe) Select AllBriefly describe what "Other" services needed*Data Controller Client ApplicationData Controller Services of Interest* Policy Development/Review Employee Compliance Training RFP/RFQ Creation/Review/Submission Counseling Contractor/Vetting/Relationship Management Expert Witness Professional Liability Insurance Review/Advocacy Contract Review/Advocacy Other Privata Vox Services (Please describe) Select AllBriefly describe what "Other" services needed*Data Subject Client ApplicationData Subject Services of Interest* Data Protection and Privacy Rights Advocacy Rights Violation Complaints/Claims Filing Expert Witness Other Privata Vox Services (Please describe) Select AllBriefly describe what "Other" services needed*Legal Professional Client ApplicationLegal Professional Services of Interest* Practice Expansion Expert Witness Other Privata Vox Services (Please describe) Select AllBriefly describe what "Other" services needed*Equipment, Software & Product Developers Client ApplicationEquipment, Software & Product Developers Services of Interest* Content Development/Ghostwriting Software Erasure Efficacy Verification Representation/Advocacy Product Evaluations & Ratings Market & Project Research Other Privata Vox Services (Please describe) Select AllBriefly describe what "Other" services needed*Terms and ConditionsConfirmation* I have read and agree to abide by the Privata Vox® Terms of Conditions Terms and Conditions Toggle Show/Hide The Terms and Conditions (hereafter, T&C) apply to the relationship, communications, transactions, and obligations (hereafter, Engagement) of Privata Vox and the cosigning Privata Vox client-organization (hereafter, Client). Privata Vox will not disclose Client-information to anyone but the designated authorized client contact(s) as defined on this Client Application, or as may be altered or augmented over time by the client in writing. Specifics regarding data protection, access, use, and retention can be found in the Privata Vox Privacy / Data Protection Policy. Privata Vox will establish and strive to meet project delivery dates, subject to Client responsiveness to intermediate approvals and materials, or other Client-based delays. Privata Vox will notify Client of any delays in project delivery timeframes with a reasonable time of such delay becoming apparent for whatever reason. Privata Vox will return all related payments to Client if it fails to deliver a designated work-product without cause within 30 days of an established deadline. Should failure to meet a delivery deadline be the result of unreasonable Client unresponsiveness, Client forfeits any deposits and other funds paid to Privata Vox. Client is responsible to prevent violations of the T&Cs by its owners, employees, contractors, consultants and agents. Unless otherwise expressly authorized by the Privata Vox in writing, the Client will; Limit distribution of any and all communications and work-product obtained as a result of Engagement, in whole or in part, in any and all forms and formats to persons within its operational domain to those with a reasonable and relevant need to be informed or included, Effectively protect any and all communications and work-product obtained as a result of the Engagement, in whole or in part, in all forms and formats, from unauthorized access by, or distribution to, individuals outside its control; Refrain from sharing any and all communications and work-product obtained as a result of Engagement in whole or in part, in any and all forms and formats, with others with the intent or to the effect that another organization may utilize or benefit. Notwithstanding the obligations herein, nothing limits Client from utilizing, benefiting from, exposing, releasing, post or distributing Engagement work-product that is designed specifically for that purpose. Unless otherwise specified in writing, Client has no right to use from using Privata Vox copyrighted content, designs, graphs, logos and diagrams, including but not limited to those in websites, literature, publications and those that may be utilized by other duly authorized organizations, without expressed written authorization from Privata Vox. Fees paid by the Client to Privata Vox in advance of Engagement designated as a Retainer are remitted as a precondition of Client’s eligibility for priority status, discounts and benefits. Retainers are not Deposits against future payment and are non-refundable. Privata Vox does not provide legal advice. Client has the prerogative to seek a legal opinion on any advice provided by Privata Vox. Client will hold Privata Vox harmless for any claim, penalty or reputational consequences stemming from the misapplication or misinterpretation of its warrants, advice or work-product. All claims and disputes arising under or relating to this Agreement are to be settled by binding arbitration. The arbitration will be conducted by Arbitration Resolution Services, Inc. (ARS) and the parties will be bound by any and all rules of ARS and any award/decision rendered. ARS rules can be found at www.arbresolutions.com. Any decision or award as a result of any such arbitration proceeding will be in writing and will provide an explanation for all decisions. Any such arbitration will be conducted by an arbitrator experienced in [insert industry or legal experience required for arbitrator, and will include a written record of the arbitration hearing. An award of arbitration will be considered final, notwithstanding reasonable evidence of Arbitrator misconduct, in which case it may be confirmed in and under the laws of the state of Arizona.