* 1. How old are you?

* 2. Are you male or female?

* 3. Which best describes your religion?

* 4. Tim Tebow frequently refers to using his "platform" as a football player for good. Has Tebow's example caused you to reflect on your own leadership opportunities, capacity to make a difference, or attitude/outlook? Please explain.

* 5. Tim Tebow is very open about his Christian faith. Has this caused you to reflect on your own beliefs/non-belief?

* 6. Has Tebow's example prompted you to make a change in your life?

* 7. Which of the following apply to you? (Check all that apply.)

* 8. Do you regularly follow NFL football?

* 9. What is your occupation?

* 10. Optional: if you are willing to be contacted for follow-up, please add your e-mail address.

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