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Request for Third Party Contact

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About You – Requester Information

As a policy we do not provide visitors with survivors’ addresses and telephone numbers. This information remains confidential in order to protect their privacy. However, in some cases the Registry of Holocaust Survivors will act as a third party and forward messages to survivors. Once you have completed this form, Registry staff will review it before a decision is made to forward it on to the survivor. If you do not hear from us, we have forwarded your message. Once the survivor receives your message, it is up to them to respond. Any response should come directly to you. For this reason, we require that you fully complete the address section below.

*Required fields
Please enter first/given name.
Please enter last/family name.
Please enter daytime telephone.
Please enter valid e-mail address.
Please enter valid e-mail address.
Please select a country.
Please enter state/territory.
Please enter city.
Please enter postal code.
Please enter address.

For whom are you searching?

The more detail you provide in your message, the more likely the survivor will respond.

*Required fields
Please enter first/given name of the survivor.
Please enter last/family name of the survivor.
Please provide message to the survivor you wish to contact.

Review and Submission

Please review the information you have filled out before your request is submitted. If everything is correct, click the Submit button near the bottom of the page.

About You

Survivor

If you are satisfied that the information above is correct to the best of your knowledge, please click the Submit button below.

Confirmation

Thank you for your inquiry. The request number is .

A confirmation e-mail have been sent to . If you do not see the e-mail in your inbox, please check your Spam folder. If you see any errors in the information you provided, or if you wish to add additional information to this request, you can contact us by responding directly to the confirmation e-mail.