CONFIDENTIALITY LEVEL FOR INFORMATION ON THIS FORM

For you:

__ Do you understand that all information you provide on this form is at your own risk

__ OK to post full identifying information on the ERAL list and to forward it to persons who we consider to be reliable, at your own risk

__ OK to use initials, or a first name, or an alias (or nickname or Craftname), and a P.O. Box or other secure way to specified above to contact you and your attorney in more publicly available media, such as Echoes or publications, at your own risk.

__ Only use initials, or a first name, or an alias (or nickname or Craftname), and a P.O. Box or other secure way to contact you specified above for all communications

__ OK to post full identifying information anywhere

Other Instructions concerning Confidentiality:

Do you have your attorney approval for the information on this form:____

Has your attorney reviewed and approved this form?___ If not, Please explain why not:

For your Attorney:

__ Do you understand that all information you provide on this form is at your own risk

__ OK to post full identifying information on the ERAL listserv and to forward it to persons who we consider to be reliable, at your own risk

__ OK to use initials, or a first name, or an alias (or nickname or Craftname), and a P.O. Box or other secure way to specified above to contact you and your attorney in more publicly available media, such as Echoes or publications, at your own risk.

__ Only use initials, or a first name, or an alias (or nickname or Craftname), and a P.O. Box or other secure way to contact you specified above for all communications

__ OK to post full identifying information anywhere

Other Instructions concerning Confidentiality:

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