Streha

Shelter, Care and Warmth for Hundred of Rainbow Hearts

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Number:

+355 69 98 39 189

E-mail:

National emergency number: 112

Ambulance: 127

Firefighters: 128

Police: 126

Police: 129

Full Name / Emri Mbiemri(required)

Email address / Adresa e-mail(required)

Date of birth / Datëlindja (day/month/year)

Place of living / Vendbanimi

What would you like to talk to us about? / Problemi juaj?

Gender / Gjinia Female / Femër

Trans female / Trans Femër

I prefer not to say / Pa përgjigje

Male / Mashkull

Trans Male / Trans Mashkull

Jo-binar

Intersex / Intersex

Other / Tjetër

Other / Tjetër (ju lutem specifikoni) :

Sexuality / Orientimi seksual Gay / Gej

Lesbian / Lezbike

Bisexual / Biseksual/e

Questioning / I/e pasigurtë për orientimin

Heterosexual / Heteroseksual

I prefer not to say / Pa përgjigje

Other / Tjetër (ju lutem specifikoni) :

If you have a disability, please tell us here. / Nëse jeni person me aftësi ndryshe, ju lutem specifikoni në vijim:

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