COVID-19 Connect
Please fill out this form if you would like us to connect you to resource.

Need help finding a job? Paying rent this month? Getting new winter jackets? Let us know and we will try to connect you to a resource.

If you are having difficulty filling out the form, please call us at: 613-686-6320

CONFIDENTIALITY NOTICE:

These relief and support services are being coordinated by UMO-OG and all information submitted on the following form will be kept confidential, with a few legal limits (for more information on legal limits to confidentiality please refer to the link below), and will only be shared and discussed with the following individuals/representatives:

Soumaya Marhnouj, Masjid Ar-Rahmah (AMA)
Momin Janjua, Director, Sidra Treehouse
Mariam Aly, Board of Directors, Ottawa Muslim Association (OMA)

Submitted information will be organized and accessed by the above team. Some of your information such as your reason for requesting support may be used for promotional material to expand the reach of the program to a wider population. Your personal information will never be disclosed except to our neighbourhood team of delivery volunteers who will only receive address, contact number, and details of items.

Legal limits of confidentiality: https://www.crpo.ca/standard-3-1-confidentiality/
Name *
Phone number *
Preferred language of communication *
Email *
The resource you most require: *
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy