Notarius Association Intake Form

This form is used after an association has decided to enter into a partnership agreement with Notarius. The data collected herein is only used for exclusive Notarius purposes and will never be sold nor shared with a third party.

1 Association Intake Checklist

2 Association and Keys Contacts

3 Partnership Information

4 Conclusion

Association Intake Checklist*
Please use this checklist to confirm that you are ready to proceed with the intake process. If you are missing some elements of the following checklist, please do not submit this form and come back when you are ready.
- I have: the association full name, official acronym, complete address, main telephone number
- I have: complete contact info for Exec Director, Director Professional Practice (or equivalent), Director Comms (or equivalent) and 2-3 AVA's
- I know who will sign the Notarius Partnership Agreement on behalf of the Association
- I can provide all the professional designations that can be selected by members of the Association
- I can describe the association approval process to sign the Notarius Partnership Agreement
- The Association has decided what option is preferred: (a) lower setup fee; (b) higher setup fee with revenue
- We have selected a tentative date for the launch of the digital signature (seal) service to our members

KEY ASSOCIATION INFORMATION
Association Official Full Name*
This is the full name that will be used in the Notarius Partnership Agreement.
Association Shorter Name*
Sometimes, the full name of some associations is too long to be included in digital certificates. If the full name of your association exceends 70 characters, please provide a shorter name that will be included in the digital certificate of your members. Please avoid using the character "&" and commas.
Association Acronym*
Provide the official association acronym
Association Address*
This address will be used in the Partnership Agreement.

Street Address Address Line 2 City Province Postal Code
Association Main Telephone Number*
Association Web Site*
Association Email Domain*
KEY CONTACTS INFORMATION
Executive Director*
Information needed: full name, title
First Last Role
E-mail*
Phone and extension*
Director of Professional Practice*
This person is considered the main contact for Notarius at the Association. In addition, this person is authorized to designate Affiliation Verification Agents (AVAs). Information needed: full name, title.
First Last Role
E-mail*
Phone and extension*
Director of Communications*
This is the person with whom Notarius will coordinate the announcement and launch of the digital signature / seal service. Information needed: full name, title.
First Last Role
E-mail*
Phone and extension*
AVA #1*
First Affiliation Verification Agent: full name, title, email, phone number and extension). The ideal person for the AVA role is already closely associated with updating on a routine basis the membership database.
First Last Role
E-mail*
Phone and extension*
AVA #2*
First Affiliation Verification Agent: full name, title, email, phone number and extension). You need at least 2 AVA's.
First Last Role
E-mail*
Phone and extension*
AVA #3
First Affiliation Verification Agent: full name, title, email, phone number and extension). A third AVA gives you better flexibility and responsiveness to member digital signature requests.
First Last Role
E-mail
Phone and extension*

Partnership Information
Approval of the Notarius Partnership Agreement*
Please describe the internal approval process for the association to sign the Notarius Partnership Agreement
Partnership Fee Option*
Please select which option the association exercises:
- Lower Setup Fee
- Higher Setup Fee + Conditional Annual Revenue to the Association
Who will sign the Notarius Partnership Agreement for the Association?*
- Executive Director (or equivalent identified previously)
- Director of Professional Practice (or equivalent identified previously)
- Other
What professional designation(s) should be available?*
Each professional association requires at least one professional designation and may have more than one. Please indicate all the professional designations available to your members as they usually appear after the names of your members. In cases of doubt, please discuss with the Notarius Vice President Business Development.
What is the tentative date for the launch of the service?*
Please indicate when you would like your members to be able to sign up for their digital signatures.
Testimonial?*
Are you receptive to developing with Notarius a testimonial after the service has been launched and operating for a few months?
- Yes
- No
- Maybe

Notarius Association Intake Form

Notarius Association Intake Form

KEY ASSOCIATION INFORMATION

KEY CONTACTS INFORMATION

Partnership Information

Conclusion