This form sends an e-mail to Angel Helpers Staff.

If you expierence any problems using this form please, copy and paste the entire form into the body of an e-mail and mail it to countryangelmomdawn@yahoo.com

IMPORTANT: Complete this form entirly, carefully and honestly, please!

First Name:
Last Name:
House Number (please still fill in if you have a PO Box, this is for our records only):
Street Name (please still fill in if you have a PO Box, this is for our records only):
Complete Mailing Address(this is if mailing address is different from above and is also for PO Boxes):
City:
State:
Zip Code:
Email:
Phone Number (where you can be reached, for our records only, we will only call if we can not get in touch with you by e-mail or snail mail):
Birthday (month and day:
Homepage (if you have one):
How did you hear about Angel Helpers (this is just so we can see where most of our advertising is from):
State a certain age for a child, please state here (if any):
Please state boy or girl here (if it matters):
Additional Comments: This is where you can tell us a little about yourself or anything else you want us to know; (feel free to tell us any thing you want, just don't use nasty language):

Please only submit this form once!

Thanks,
Angel Helpers Staff

Please know we do not keep your information stored on an online data base or computer, everything is kept off line on a diskette for are records only, this is so that no one at any given time can just access your information for any reason what-so-ever, it is for Angel Helpers Staff only! This is also for your protection and privacy, since we live in a world that has so much danger, we must take every caution to provide saftey for you here at Angel Helpers.

The Angel Helpers Staff, respects your right to privacy and will not in any way what-so-ever, at any time, give out, share or sell your information to any third parties for any reason, not even with your written permission. We believe if you want to give it out to anybody but us here at Angel Helpers you should do that. Also we believe that it is not our responsibility to do so for any given reason at all. So your privacy is protected with us here at Angel Helpers.

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Angel Helpers © 2003
All Rights Reserved by Angel Helpers
Page Last Updated: August 27, 2003