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Affirm the Darlington Statement
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* Indicates required question
Email
*
Your email
I affirm the Darlington Statement
*
I am a person with an innate variation of sex characteristics
I am a family member
I am a person who is an ally
I represent an ally institution, organisation or business
Details about you/your institution
My expertise/my organisation's expertise
Public Supporter - No affilitations
Intersex-specific/variation of sex characteristics-specific support/rights/services
Intersex-led/variation of sex characteristics-led support/rights/services
Health professional/health services
Medical professional/medical services
Legal professional/legal services
Human rights practitioner/institution
Academic/education practitioner/institution
First Nations support/rights/services
Disability support/rights/services
Lesbian/gay/bisexual support/rights/services
Transgender/gender diverse support/rights/services
Government body
Media/journalist
Other:
Add your testimonial or comments
Your answer
Contact details
Contact name (as to appear in list of signatories)
*
Your answer
Organisation name (if applicable)
Your answer
Contact phone number
Your answer
Contact address
Your answer
Consent
I affirm the Darlington Statement
*
Yes
Other:
I consent to the publication of my name/my organisation's name in the public list of signatories
*
Yes
No
Other:
I consent to anonymised publication of any comments or testimonial
Yes
No
Other:
Clear selection
I consent to IHRA, AISSGA and ITANZ placing my/my organisation's name on a private list of referral organisations for individuals seeking affirmative service providers. If yes, please write name of service
Yes
No
Other:
Clear selection
I would like to be contacted about making a donation to support the progression of intersex human rights and peer support in Australia and Aotearoa/NZ
Yes
No
Clear selection
A copy of your responses will be emailed to the address you provided.
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