Data Request Form

Full Name:

What email do we have on file for you?

Who is submitting this request?

The person, or parent/guardian of the person, named above

An agent authorized to make this request

Under the rights of which law are you making this request?

I am submitting a request to:

Know what information is being collected from me

Have my information be deleated

Request a copy of my data

Other (please specify in the box below)

I confirm that

Under penalty of perjury, I declare all the above information to be true and accurate.
I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with Spokane Helpers Network.
I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.