Community contact list new group form

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Please correct the field(s) marked in red below:

1

Name of Group:

 *
2

Contact Person Name:

 *
3

Home Phone Number:

4

Work Phone Number:

5

Cell Phone Number:

6

Email:

7

Website:

8

Mailing Address:

9

Street Address (if different):

The personal information that you provide to the City of Lacombe is collected under the authority of the Alberta Freedom of Information and Protection of Privacy (FOIP) Act – Section 33(c). The information will be used for the purpose of managing and publishing a contact list of community organizations.

Collected personal information is protected from unauthorized access, collection, use, and disclosure in accordance with the FOIP Act, and can be reviewed and corrected upon request. Questions regarding the collection of personal information can be directed to: FOIP Coordinator, City of Lacombe, 5432-56 Ave, Lacombe, AB T4L 1E9, Tel. 403-782-1281 or foip@lacombe.ca.
  1. To receive a copy of your submission, please fill out your email address below and submit.