Mug Delivery Report Form Mugger Report Report from the Delivery of Mugs to First-Time-Visitors Date of Report* Name of Person Making Report First Last Email of Person Making Report Names of First Visitors (LASTNAME, FIRST NAME(s))*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneVisit Information* Home Not Home Left Note + Mug Contacted by Phone Indicated they would visit again Requested a Pastoral Visit (or you perceive that they need one) Please Check ALL that apply:Additional information you would like to share?Is there a second visitor whose information you would like to enter?*YesnoSelect one Thank you, now please click "Submit" below.Names of Second Visitors (LASTNAME, FIRST NAME(s))*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Visit Information* Home Not Home Left Note + Mug Contacted by Phone Indicated they would visit again Requested a Pastoral Visit (or you perceive that they need one) Please Check ALL that apply:Additional information you would like to share?Is there a third visitor whose information you would like to enter?*YesnoSelect one Thank You, now please click "Submit" below.Names of First Visitors (LASTNAME, FIRST NAME(s))*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Visit Information* Home Not Home Left Note + Mug Contacted by Phone Indicated they would visit again Requested a Pastoral Visit (or you perceive that they need one) Please Check ALL that apply:Additional information you would like to share?Is there a fourth visitor whose information you would like to enter?*YesnoSelect oneThank you for your help, Please click "Submit" now.Names of First Visitors (LASTNAME, FIRST NAME(s))*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Visit Information* Home Not Home Left Note + Mug Contacted by Phone Indicated they would visit again Requested a Pastoral Visit (or you perceive that they need one) Please Check ALL that apply:Additional information you would like to share?Is there a fifth visitor whose information you would like to enter?*YesnoSelect oneThank you for completing this form. Please click "Submit" now.Names of First Visitors (LASTNAME, FIRST NAME(s))*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Visit Information* Home Not Home Left Note + Mug Contacted by Phone Indicated they would visit again Requested a Pastoral Visit (or you perceive that they need one) Please Check ALL that apply:Additional information you would like to share? If there are additional visitors, please hit "Submit" below, then begin a new form. Thank You, now please click "Submit" below. 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