Data Access Request form

You are here:

Home
Data Access Request form

Please complete this form to receive a report about your personal data collected by Lennoxville & District Community Aid. Your report will be sent within 15 business days. You can also use this form to update or delete any information we have about you.

Name(Required)

First Last

Which email address have you used to access our services?(Required)

You are submitting this request as:(Required)

The person mentioned above

A third party, authorized by the person to make this request

I am submitting a request to:(Required)

Receive a report about which personal data is collected by me

Have my information changed

Have my information deleted

Other

Do you have any comments to add?

Phone

This field is for validation purposes and should be left unchanged.