I agree to the following:

  1. All my answers on this application are true and complete and I require the services represented in this application.
  2. I am not providing any confidential information, only the minimum amount needed to describe my situation for purposes of finding an appropriate professional, and do not expect confidential treatment of the information.
  3. No attorney-client relationship or privilege exists from the submission of this application.
  4. Falsification, omission, or misrepresentation of fact on this application or any other accompanying documents may result in immediate termination of the relationship between PIIPA and myself and any organization I may represent.
  5. I have the authority to act as a representative of any organization referred to herein.
  6. PIIPA may contact me by any means, including phone, fax, mail, or email.
  7. PIIPA may release my contact information for informational purposes to its IP Corps members, collaborators, and donors; and they may contact me by any means (including phone, fax, mail, or email).
  8. By submitting this application I am requesting that PIIPA attempt to find me one or more professionals who may be willing to independently consider representing me and that I understand PIIPA is only providing a professional locator service and that the role of PIIPA does not extend beyond that;
  9. I understand PIIPA has made no independent verification of the credentials of the IP Corps members, and PIIPA makes no guarantees, representations or warranties as to its abilities to suggest an appropriate professional, or as to the actions, abilities, credentials, knowledge, or conduct of any professional it may suggest.
  10. I will not hold PIIPA or any of its members accountable or liable in any way for their role in this service – the only legal remedies available to me are against any professional I have independently approached and with whom I have entered into a contractual relationship.
  11. I agree to the Terms and Conditions of using the www.piipa.org website.

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