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Alliance Referral System
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Membership
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Accreditation
About Accreditation
Enhancing Credibility
Events
Event Calendar
Sheltered Conference
About Us
Who We Are
Public Reports & Press
Contact
Jobs
Work With Us
Job Board
Post A Job
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Join The Arbor
Request A Speaker
Church Partnership
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Complaint Information Release Consent
Information Release Consent Form
(Required)
I hereby give my permission for the National Trafficking Sheltered Alliance (NTSA) to release information shared in a complaint by me, the Complainant, at a meeting with NTSA Staff. The released information will be used to notify the accused organization that a complaint has been filed against it and/or its staff, and the organization also will be informed of the nature and details of the complaint. I authorize NTSA to disclose the information in my complaint immediately upon NTSA’s receipt of this letter, and that authorization will remain in effect indefinitely, or until I revoke this authorization in writing. I may choose to revoke this authorization at any time. I understand that NTSA will attempt to maintain my confidentiality and anonymity where possible in disclosing details of my complaint. Details will be disclosed only to the extent that NTSA—in its best judgment—believes is necessary to address and rectify any concerns raised by me, the Complainant. However, I acknowledge that my identity might be revealed or discovered by the accused organization, despite NTSA’s good faith efforts to maintain confidentiality.
Name
(Required)
First
Last
Complainant Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Date
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