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* 1. My name is:

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

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* 3. I do not attend St Andrews because

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* 4. I first attended St Andrews in the

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* 5. I first heard of St Andrews through

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* 6. I am

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* 7. I am

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* 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)

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

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* 10. Please add any further comments:

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