UNITED SIKHS::Recognize the Human Race as One


Title
First Name		*
Last Name		*
DOB		*
Address		*
City		*
Province
Zip Code
Email		*
Daytime Tel.		*
Evening Tel.
Ethnicity


Consent:	I hereby consent to UNITED SIKHS storing and processing the personal information provided by me on the form above in accordance with their Privacy Policy.UNITED SIKHS will only share this information with The Canadian Blood Service or its successor who will deal with the information in accordance with their Privacy Policy. UNITED SIKHS will not share this information with any other third party.
Disclosure:	By entering and submitting individual information on this form, UNITED SIKHS will processes and store your personal data to respond to your query or comments, maintain a donor database, retain contact information and to develop and improve the services we provide. Should you need to update your information, please feel free to contact UNITED SIKHS.