GMFRC E-mail Newsletter Registration Form

Please provide the following Personal Information:

Name
Unit/Section
Work Local
Home Phone
E-mail

Town of Residence (for statistical purposes only):     

Family Primary Language:                    English     French     Bilingual

Feedback

In order to find out if this service is working for you, we need your feedback. 
Do we have your consent to contact you either by phone or by e-mail in order to conduct a yearly evaluation of this service:

Yes   you have my consent to contact me in regards to the evaluation of this service

No    I don’t want to participate in the evaluation of this service

GMFRC PRIVACY CODE - Please read carefully
The information on this form will be kept confidential and used only for the purpose for which it is
collected within the Greenwood Military Family Resource Centre.  The Greenwood MFRC adheres
to the Military Family Services Privacy Code

AUTHORIZATION INFORMATION
By submitting your completed form, you are automatically authorizing us to e-mail you information
on our programs and services on a quarterly basis.  You are also giving us your consent to disclose
this information to the GMFRC staff and registered volunteers with respect to the above-indicated service.