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Registration Form for Hygiene and Winter Assistance Kits Distribution

We’re here to support you. If you need a hygiene kit and a winter kit, please fill out this form so we can make sure you receive them. Each person who registers will get one hygiene kit and one winter kit. Filling out this form will help us organize the distribution quickly and fairly, so you can get the support you need.
1.E-mail address(Required.)
2.City(Required.)
3.Name and Surname(Required.)
4.Country of origin(Required.)
5.Employment status/work(Required.)
6.What is the monthly net income per person in your household?(Required.)
7.How many children (persons under 18 years old) are there in your household(Required.)
8.Do you need material support(Required.)
9.What time would you prefer to receive support?
10.I confirm I will come to pick up the support kits(Required.)
Questions for statistical purposes
11.Gender
12.Age
13.Does anyone in your household have a disability?
14.Do you need psychological support?
15.Do you need any other support? What kind?
Your data controller is Project HOPE Polska, 31-511 Kraków, Rakowicka 8 st.

We will use your data only to:
  • register you to receive humanitarian kits (hygiene and winter kits),
  • organize the distribution efficiently and fairly,
  • create anonymous reports and statistics (without identifying you).
Providing your data is voluntary, but necessary if you want to receive assistance.

Your data may be shared only with Project HOPE Polska staff and partners helping with distribution under a data protection agreement.

Data will be stored only as long as needed for the project and reporting, then deleted or anonymized.

You have the right to:
  • access your data,
  • correct it,
  • delete it or restrict processing,
  • withdraw consent at any time (without affecting past processing),
  • file a complaint with the President of the Personal Data Protection Office.
Your data will not be used for profiling or automated decisions.