* 1. My name is:

* 2. How often, on average, do you attend Sunday worship at St Andrew’s?

* 3. I do not attend St Andrews because

* 4. I first attended St Andrews in the

* 5. I first heard of St Andrews through

* 6. I am

* 7. I am

* 8. Outside of attending Sunday service, how else have you participated in the life of the church?  
Please record all that you can recall.
(Some examples: Sunday School, Choir, Session, WMS, Bible Study, Koinonia, Breakaway, AKD)

* 9. I am interested in being contacted for further discussion:

* 10. Please add any further comments: