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I am writing to provide notice that I'm opting out of the Agreement to Arbitrate in the Glassdoor Terms of
Use. Pursuant to the terms of the Agreement to Arbitrate, I'm providing the requested information as
follows:
My Name:
_________________________________________________________
My Street Address:
_________________________________________________________
_________________________________________________________
_________________________________________________________
Zip Code:
_________________________________________________________
Phone Number:
_________________________________________________________
Email Address(es) associated with the Glassdoor account(s) for which Im opting out of the Agreement to
Arbitrate: (Please let all email addresses associated with the account(s)).
_____________________________________________________________________________________
_____________________________________________________________________________________
Signature:
_________________________________________________________
Date:
_________________________________________________________