Crystal Kuykendall - Questionnaire

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Questionnaire

Thank you for taking the time to complete this two part Questionnaire. In submitting your responses, you are consenting to have all or part of this information included in the upcoming book, Happiness Is Having/Being a Merchant of Hope. Please answer all questions completely and truthfully. If your information is not selected for inclusion in the book, your responses will be kept confidential and will not be shared with any other source. Thanks again for your participation. Continued success to you in all current and future endeavors.

Part 1: Personal Information

Name:

Title/Occupation:

Address:

Address line 1
Address line 2
City
State/Province
Zip/Postal Code

Phone (Day):

Phone (Evening):

FAX:

Email:

Age (Optional):

Are you
responding as?
(check one)

a). One who has served another as a "Merchant of Hope"
b). One who has benefited from the efforts of another "Merchant of Hope"
c). One who has observed the efforts of a specific "Merchant of Hope"