Name *

First Name

Last Name

Address

Your address will only be used to send you confirmation of our $5 donation in your name.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would consider myself a spiritual person. *

Yes

No

Sort of

I would consider myself a religious person. *

Yes

No

Sort of

I would consider myself a Christian. *

Yes

No

Sort of

I grew up going to church. *

Yes

No

Sometimes

Religion, Christianity, and church is outdated and a thing of the past. *

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Do any of the following put you off or discourage you, personally from going to church? (Mark ANY that apply)

The beliefs the church holds.

The church service is too boring or unfulfilling.

Personally bad experiences with church people or pastors.

I feel uncomfortable with the sort of people who go to church.

The moral views of the church.

The way churches are organized.

There are no churches of my denomination nearby.

I have no transportation or way to get to church.

I see no need for church.

I do not have enough time for church/other commitments.

I'm interested in learning more about Jesus. *

Yes

No

I'm interested in learning more about Holy Trinity Church and its work in the community. *

Yes

No