NSA NAPLES Religious Needs Assessment Thank you for attending AO and for completing this Religious Needs Assessment. Your feedback will help us to serve YOU better! - Chaplains Foshee, Tiongson, Kim, and Hall Question Title * 1. NAME Question Title * 2. Phone No. Question Title * 3. Email Question Title * 4. Marital Status Married Single Divorced Separated Other Question Title * 5. Number of Children Question Title * 6. My Religious Preference Atheist African Methodist Episcopal Buddhist Baptist (specify below) Catholic Christian Church (Disciples) Christian, Non-Denominational Church of Christ Episcopal / Anglican Hindu Islam Jewish Latter Day Saints (Mormon) Lutheran (specify below) Methodist (specify below) Orthodox (specify below) Pentecostal Presbyterian (specify below) Protestant, other (specify below) Reformed Seventh Day Adventist Sikh Spiritual, but not Religious Unitarian Universalist United Church of Christ (UCC) Wicca No Religious Preference Other (specify) Other (please specify) Question Title * 7. Do you have any religious needs, accommodation requests, or requirements you would like the Chaplains' Office to provide or advocate for you? Question Title * 8. Are there any specific programs you are interested in? Marriage Enrichment Women's Fellowship Community Service / COMREL Pre-Marital Counseling Small Groups Youth Group Religious Education / Bible Study Choir / Worship Team Spiritual Growth Lay Leader CREDO Retreat Other (please specify) Other (please specify) Question Title * 9. If you would like to meet with a Chaplain, please stop by, or call 626-3539 (Capo) or 629-4600 (Support Site). Thank you for your feedback. Please make additional comments here: Done