Surviving Violent Crime & Victims' Rights Handbooks Digital Copy Request

Surviving Violent Crime & Victims' Rights Handbooks Digital Copy Request

By completing this form, the NCVAN website will pop-up for you to download the ENGLISH and SPANISH handbook PDF. Please complete the form to your level of comfort. The first three questions are the ONLY required questions. Questions? Email us at info@nc-van.org
First and Last Name (or Alias/Nickname)*
I am a: *
Primary Criminal Victimization: Select the option below that best applies for the person needing victim services. *
Email
example@example.com
County
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
*Notice* the next two pages are OPTIONAL. Continue to the "Submit" button at the bottom of page 3 if you wish to NOT answer additional questions.

(OPTIONAL) Please complete the following questions based on your level of comfort.

Collecting demographic information of victims (or the loved ones of victims) helps us (and our funders) to better understand what groups in the community we are and are not serving so we can improve our outreach, but it is always optional. You do not need to answer these questions to receive a handbook, but we do appreciate any information you are willing to provide. Skip until the "Submit" button if you are not interested in completing the questions below.
Date of Birth

MonthDayYear
Date
Ethnicity
Gender Identity
(Select all that apply):

Deaf or Hard of HearingHomeless (Includes those residing in shelters or in other temporary housing such as a friend's couch)ImmigrantLGBTQIA+VeteranPerson with Disabilities: Cognitive or PhysicalLimited English ProficiencyNone of the above or prefer not to answer / Ninguna de las anteriores o prefiero no contestar

Notice the next two pages are OPTIONAL. Continue to the "Submit" button at the bottom of page 3 if you wish to NOT answer additional questions.