홈으로 충북이주여성상담소 상담신청 영어

영어

충북이주여성인권센터는 생명, 평등 ,평화를 이주여성과 함께 합니다.

Consent to provide and use of personal information (required)

  • The center uses collected personal information only for counseling. If you would like to reject to use collected personal information, you could ask open, modify, delete through the manager.
  • Items to be collected : All personal information from this application
  • Follow 「Personal Information Protection Act」 etc, Do you agree to be collected personal information like below part?

  Agree          Disagree

  Mark is required

Name Contact
Information
Date of birth Employment
(JOB)
Do you have Children?  Yes         No
Country of birth Visa type
Content of counseling  Domestic violence         Violence         Sexual violence         Sexual trafficking(prostitution)       
 Etc ( )
If you would like to have counseling in person, Fill this section.
Method of counseling  By call         In center         Counselor visit         SNS(message)       
 Etc ( )
Type of content  Domestic violence         General violence         Sexual violence         Sex trafficking(prostitution)
 Married couple         Family         Divorce         legal         Visa         Labor         Dating violence, Stalking
 Psychological counseling
 Etc ( )
Available date for counseling  Year    
 month     day

Please write the possible date and time for consultation visit

 Do you need translator?  Yes         No

** The date of application is automatically entered **

We ensure your information of application and counseling content confidentiality.

Chungbuk Counseling Center for Migrant Women