Response Card

12_227341-C_Richardson_Response Card.pdf

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Response Card

OMB: 0920-0919

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CS227341

SEED

Study to
Explore Early
Development

We hope you and your child
will take part in SEED!
Please contact us to learn more.
Step 1: Check one of the boxes below

You are under no obligation to take part in the
study if you contact us. But, you will receive a
$10 gift card if you contact us and answer a few
short questions -- even if you decide not to take
part in SEED.

		

YES, please contact me. I would like to learn more about SEED 	

		

NO, I am not interested in learning more about SEED

Follow Step 2 or Step 3:

Step 2: Complete the following information and mail this card to us in the pre-paid envelope.
Name					Home Phone
Address					Cell Phone
					Other Phone
I prefer to be reached by:
Email

Step 3: You can contact us.
	
	

by phone at 404-498-0058 or
by email at [email protected].

Telephone	

E-mail

Best time to reach me is:	
Morning

Afternoon

Early Evening

If you email us, give us your name
and a telephone number where we can reach you.


File Typeapplication/pdf
File Modified2012-06-13
File Created2012-04-27

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