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First Name

Primer nombre

Last Name

Apellido

Date of Birth (MM/DD/YYYY)

Fecha de nacimiento (MM/DD/AAAA)

Note to FA Moderation

The purpose of this form is to create a secure way for participants at our nonprofit to update their information. We originally intended to allow participants in our food bank services to update their information based on providng us with their First Name, Last Name, and Birthday - then using the Salesforce prefill connector to populate their email, address, and other demographics we maintain to track our service population. After some discussion, we realized that some of our participants may be in a domestic violence situation and thus a partner or other threat to their safety that knows their birthdate might be able to use this form to access sensative information. Thus, we're exploring whether we can let each person create a unique password that only they would know, and use that to access their information. This form is not trying to mine a participants password from any other site. It is only to allow participants a secure way to update their information with us, as (per our government grants) we need to collect certain pieces of demographic information to serve them.

Contact Information