The Memory of Treblinka Foundation

The Memory of Treblinka Foundation in cooperation with Jewish Historical Institute collects all available information concerning the victims of the extermination camp in Treblinka. We do not want to allow for them – as the Nazis would have wished – to remain anonymous. Every name is important to us. If you would like to share with us any information about your family or friends, we would be very grateful for completing on-line questionnaire below. Even just a partially completed questionnaire would be very valuable to us.

The questionnaire is also available as a word document. Filled and signed should be scanned and sent by e-mail or (original) by mail to Foundation: The questionnaire “Book of Names”.doc

Data of more than one person can be sent in separate or in one questionnaire. If you do not know the exact date of birth, please give an approximate one. If the detailed address is missing, then maybe just district or town is known.

If you have any souvenirs, letters, photographs or other documents pertaining to the people you’re describing, we would be very thankful for making them available to us for copying.

As we’d like to be formally entitled to insert the data passed by you into Foundation database, we need your formal confirmation. The questionnaire filled on-line we will send to you. Please sign it and send us back.

If in future you’d like to update sent data please contact Foundation.


QUESTIONNAIRE

Name and surname – if applicable, names used previously, in the case of women – maiden names

Date and place of birth

Place of residence (before and during the war – in which ghetto was the person placed)

Parents’ names (mother’s maiden name)

Education

Trade (before and during the war)

Place of death

Other information, e.g. date and place of deportation, circumastances of the deportation of a given person (or family). If you have a longer story to tell, we will contact you to hear it or you can send it to us via email or mail.

Spouse (name and surname, date of birth, trade)

Children – names and dates of birth (age), other information, e.g. names of schools, participation in organizations

Alternatively, please list other people who were murdered in Treblinka

In what relation to you was the person (people) described?

What is the source of information about the person described? (obligatory)

Name and surname of the person completing this questionnaire (obligatory)

Contact details – email address (obligatory)

Contact: address and telephone (obligatory)

Date of completing the questionnaire

Consent to Personal Data Processing
The data controller as defined in the General Data Protection Regulation and relevant data protection legislation (GDPR) is The Memory of Treblinka Foundation, Tłomackie Street 3/5, 00-090 Warszawa, Poland.
By providing the Foundation your personal data, you declare that you have read and expressly accepted the Foundation Privacy Policy and consequently give your free, specific, unequivocal and informed consent that your personal data shall be processed by the Foundation in accordance with the provisions of the Privacy Policy for the scientific or historical research purposes and primarily for the creation of a list of victims of the Treblinka II extermination camp. If you refuse to consent or to provide the required data The Foundation will not include the data you provide in your testimony into the Treblinka II victims database and will not process your personal data as described in the Privacy Policy.
You also acknowledge and agree that the personal data you provided may be disclosed to entities being Holocaust data processors as well as to those processing the data for scientific or historical research purposes subject to the conditions described in our Privacy Policy. We may also disclose personal data to the contractors to implement appropriate technical and organizational measures to ensure safety of the personal data.
If you believe that the processing of your personal data is contrary to the GDPR rules you may lodge a complaint with the supervisory authority.
Further information is available within our Privacy Policy. If you have any further questions you may also read our Q&A page or directly contact our office.

I hereby give my free, specific, unambiguous and informed consent for my personal data included in my testimony to be processed for the purposes of scientific or historical research including the creation of a list of victims of Treblinka II extermination camp in accordance with Privacy Policy.

I hereby give my free, specific, unambiguous and informed consent to disclose my name, surname and my connection to the victim only to other entities collecting data of victims of Holocaust or conducting scientific and historical research, provided that they sign with the “Memory of Treblinka” Foundation an agreement regulating the processing of personal data by these entities in accordance with the applicable law.

I hereby give my free, specific, unambiguous and informed consent to share my name, surname and my connection to the Holocaust victim on the universally accessible website of the " Memory of Treblinka" Foundation.