E-Gov Services City of Harlingen

Parks and Recreation

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Purpose. Please help the Parks and Recreation department update the 5 year plan. We are looking at you the community to help us better serve you. Please take a minute and fill out this short survey, this information will be valuable to us. Bring the completed survey to the Doyle Community Center by June 1, 2005 and we will give you a free (day pass or aerobic pass) at the Doyle Community Center.

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Contact Information

* First Name:
* Last Name:
Business Name:
Email:
Daytime Phone:	() –
Fax:	() –
Address:
City:
State:
ZIP:

Issue/Problem Location:

* Address	- Or Other Not Listed - Invalid Address The address you entered does not match any in the system. You can select a valid address from the list, or if you are certain the address you entered is correct click the "Use the address I entered" button, to continue. The address you entered
Unit:
	Provide any additional information on problem location in the box below.

1. Plese write your comments.

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Notes:

If you send us a message, you will receive a Tracking Number allowing you to follow-up with your request, at your convenience.

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