Ronald McDonald House Charities

Privacy Information Request

Instructions

Please fill in all fields below, print out the form and then fax or send by postal mail.

If you wish to return this form via fax:
Fax: 630-623-8853

If you wish to return this form via postal mail:
Ronald McDonald House Charities
RMHC Privacy Policy
One Kroc Drive
Oak Brook, IL 60523

First Name:
Last Name:
Address:
City & State:
Zip Code:
E-mail:
Your Request:	Please Delete my personal information.
	Please Discontinue further use of my personal information.
	Please Provide me with all the personal information you have collected.
By signing this form, I attest to the fact that I am the individual named above.
______________________________ Signature		_________________ Date