Canadian Human Rights Commission :: Publications Request Form

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Publications Request Form

* indicates a mandatory field

Contact Information

#1 *Language:

#2 *Title:

#3 *First Name:

#4 *Last Name

#5 Job title:

#6 Organization:

#7 *Street Address:

#8 *City:

#9 *Province or State:

#10 *Postal or Zip Code:

#11 *Country:

#12 *Area or International Code:

#13 *Telephone Number and Extension:

#14 Fax Number:

#15 *Email Address:

#16 Please indicate the number of copies and which publication(s), report(s) or other materials you would like to receive*.

#17 Publications are also available in multiple formats on request. Please indicate below the name of the publication and the format (Large text, Braille, MP3, etc.)

#18 Do you have questions or comments? Please indicate below: