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이주여성이 안전한 세상, 강원이주여성상담소입니다.

Consent to provide and use of personal information (required)

  • Personal information will not be used for any purpose other than counseling, if you want to refuse the use of the provided personal information, you may request to view, correct, or delete through requesting the in charge.
  • Collection items: All personal information registered in the consultation application
  • In accordance with the Personal Information Protection Act, etc. I agree to provide and use the personal information as above.

  Agree          Do not agree

  Mark is required

Name

Contact No

Date of birth

 달력

Occupation

Child

  Have children          No children

Birth country

Status of stay(Visa)

Consultation content

 Domestic violence         General violence         Sexual violence          Prostitution       
 Other ( )

Fill in the following content, only if you want to consult directly with a counselor

Consultation method

 Telephone         Self-visit         Consultant visit         SNS(message)       
 Other ( )

Consultation Type

 Domestic violence         General violence         Sexual violence         Prostitution         Marital conflict         Family conflict         Divorce problem         General law         Sojourn problems         labor issues         Dating violence, Stalking         Psychological counseling
 Other ( )

Desired date and time for consultation

calendar    hour   minute

Please write the possible date and time for consultation visit

Translation

  Need          Not needed

** The date of application is automatically entered **

Counseling application and content of consultation are conducted in private.

Gangwon Counseling Center for Women Migrants preciousness