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PCI-DSS SAE Acknowledgement of Participation

Every individual who handles Cardholder Data must review the PCI DSS Security Policy and Program and acknowledge he or she has read, understands and will abide by the Northwestern PCI Security Policy.

Before completing the acknowledgement below, please make sure that you have your 3 digit merchant card location number. If you work with more than one location number, you may submit a comma delimited list of the locations in the space provided. For example: 013, 120, 467.  Please contact your department or school administrators, or Joseph Stolz, if you have questions about which location ID(s) to use.

* Required
(REQUIRED)
(REQUIRED)
Enter the 3 digit MID (merchant ID number) of your credit card operation
(REQUIRED)
  • Other:
(REQUIRED)
(REQUIRED)