Parent Survey Prize Entry 2016

Parent Survey Raffle Entry

Thank you for filling out the 2013 LaneKids Parent Survey!

Raffle entries and survey responses are collected separately. Survey responses are confidential and anonymous. Only one entry per family.

Please provide your contact information below to be entered in a drawing for gift cards to:

Fred Meyer

Safeway

Target

Dutch Bros.

Off the Waffle

Passes to Splash! at Lively Park, The Science Factory, Bounce Gymnastics, & more!

Prize winners will be notified by June 15th, 2016.

Question Title

* 1. Name

Question Title

* 2. Address

Street Address

Apt. #

City

State

Zip

Parent Survey Prize Entry 2016

Parent Survey Raffle Entry

Question Title

* 1. Name

Question Title

* 2. Address

Question Title

* 3. Phone

Question Title

* 4. Email