Electronic Signature Consent Form

I am giving my consent to (INSERT NAME OF FACULTY, USE

MR/MS/MRS/ENGR/DR), course instructor/professor, to use my e-
signature attached to this form for my acknowledgement of the
course syllabus on (INSERT the Course, e.g. Elec 3- Bridge
Engineering) and be contain on FM-AA-CIA-04 QMS FORM
(Acknowledgment Receipt of Syllabi by the student) this INSERT
SEMESTER. 

By signing this Electronic Signature Consent Form, I agree that

my electronic signature is equivalent to my handwritten signature
and shall only be used as stated above.

                        
              
   NAME (ALL CAPs and BOLD)                  DATE
  Signature over Printed Name of Student          Date Signed