Survey



Connectedness


YesNo


YesNo

If you are connected:



As in, Family table, DBS






YesNo



If you are not connected:


YesNo



Who of your family is connected to Lighthouse?









Contact Details











MaleFemale





EnglishAfrikaansOther








Please add your home, work or cell number.







Employment





YesNo




YesNo




YesNo

If yes, please eloborate.




Transport:


YesNo





YesNo