Hindu Temple of Southwest Florida, Inc.

A Non-Profit Corporation

Registered Office: 563 Peck Avenue, Fort Myers, FL 33919

(239) 482-0677

Thank you for supporting the Hindu Temple, with Ganesha as the main deity. After a few months of planning and fact-finding, our Temple Board has started the preliminary steps for building a Temple. In order to arrive at an architectural plan and to determine the cost of the building, we need some idea of the deities that will be installed in the Temple during the several phases of construction. As we are planning to build a temple that meets OUR community's needs, we need your input, so the Board can decide on the remaining deities. The final deities will be decided based on the feedback that is received.

Please encourage all your friends to complete this survey and mail it by July 15^th, 2004.

This may be mailed to the above address or emailed to webmaster@hindutemple.faithweb.com

Limit one entry per adult.

Devotees completing survey must live in Southwest Florida or must have contributed to the Hindu Temple of Southwest Florida.

Om Gam Ganapathaye Namaha

Please indicate your choices below.

1. Ganesha __________________ Granite

2. __________________________ Granite Marble

3.___________________________ Granite Marble

4.___________________________ Granite Marble

5.___________________________ Granite Marble

Please circle Granite or Marble for the statues. Abhishek with water, milk, etc. can be done only on Granite.

Suggested deities: Ram Parivar, Radha-Krishna, Shiva lingam, Shiva (in meditation), Shiva-Parvati, Gayatri, Lakshmi, Saraswati, Durga, Annapoorna, Venkateswara, Vishnu, Navagraha, Subramanya, Ayyappa, Hanuman, Mahavir, Jalaram.

Please fill in your name and address below. For your choice to be considered your name MUST appear on the form. All responses kept confidential.

Name _____________________________

Address__________________________________________________

Phone___________________ Email___________________________