HOW CAN WE REACH YOU?
Please fill in the information below, and send this piece of paper back to us in the envelope.
Or call us for FREE at 1-800-XXX-XXXX.
Name:___________________________________________________________________
Home phone: (________) ________-___________ Cell phone: (________) ________-___________
Any other phone numbers where we can reach you? Family member? Friend? Caseworker Payphone?
(________) ________-___________ (________) ________-___________
Circle ALL best times to reach you: 7am to 10am 10am to 1pm 1pm to 4pm after 4pm
If you would like to do the interview now, or if you have any questions, please call us on our FREE project line at 1-800-XXX-XXXX, or email Survey Coordinator, Barbara Levitan, at [email protected].
Remember, the interview
is FAST, EASY, and IMPORTANT. AND, we will pay you $10 for
completing it.
Rev. 12.07.07 OMB# XXXXXXXX
| File Type | application/msword |
| File Title | Count |
| Author | Daniela Golinelli |
| Last Modified By | Erica Czaja |
| File Modified | 2007-12-07 |
| File Created | 2007-12-06 |