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All Information given to Salaam will be kept in strict confidence.

Volunteers directly involved in events planning for Salaam will be the only ones with access to this information. For instance, Information that you provide to Salaam will be used with your consent to inform you of upcoming events. You will be asked to sign our confidentiality policy prior to accessing our records.

Name:
Gender:
(e.g. Male, Female, Female to Male, Tran gendered, Male to Female, Other):
Age:
Sexual Orientation:
(e.g. Gay, Lesbian, Bi-Sexual, Heterosexual, Questioning, Other):   
Ethno Cultural Background:
(Optional) (e.g. Turkish Canadian, Indo-Canadian):
Email Address:
Home Telephone Number:
Work Telephone Number:
If discretion is a concern please provide us with detailed instructions on how to contact you and when we call or write.:
Do you give Salaam permission to use your contact Information to inform you of upcoming events?: Yes No
Date:

 

 

 

                                              Last Update July,2003          webmaster@salaamcanada.com