If you wish to have someone from the Couples' Network contact you and/or your spouse/partner, please copy the following form and paste it, along with your answers, into an email to us. It's easy, simply highlight the questions, select "Edit" from your browser, then "Copy". Click on the email graphic below. When the letter opens up, place the cursor in the body of the letter. Again, select "Edit" from your browser and then "Paste." Please make sure to fill in the answers.
We will do our best to respond to you quickly.
Name/Femme Name:______________
Partner's Name:__________________
Safe Mailing Address
Mailing Name: ______________________
Street/Box Address:__________________
City, State, Zip:______________________
Email Address: ______________________
Does your spouse/SO know about your livestyle? ____Yes ____No
How long has she known?_______
Tell us what you would like us to do.
_____I would like more information about the Couple's Network
Please have one of the members of the Couple's Network:
____contact me
____contact my spouse/SO
____contact both of us
____do not contact my spouse/SO
Please contact me/us via:
____Email
____ Snailmail
____Telephone at_______________
Do you have specific issues you want us to address? ____