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2. Name of Group*
4. Contact Person Name*
6. Home Phone Number
7. Work Phone Number
8. Cell Phone Number
10. Email
12. Website
14. Mailing Address
16. Street Address (if Different from Mailing Address)
20. 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.
22. 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.
24. Questions regarding the collection of personal information can be directed to the FOIP Coordinator.
    Contact the FOIP Coordinator
28. To receive a copy of your submission, please fill out your email address and submit.
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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