Exit this survey Contact Information Form * 1. Head of Household Name * 2. Home Address: * 3. Home Phone #: * 4. Home Email Address: * 5. Name: * 6. Mobile Phone #: * 7. Work Phone #: * 8. Work Email Address: * 9. Name: * 10. Mobile Phone #: * 11. Work Phone #: * 12. Work Email Address: * 13. What method(s) of communication do you prefer the Parish use to send information? Hard copy (paper) sent to my home postal address E-mail (enter email address below) Parish Facebook account (Remember to Friend us!) * 14. If you prefer to be contact by email, please enter email below. Done