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* 1. What is your name?

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* 2. Are any members of your family affected by diasbility?

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* 3. Do your family members attend church regularly

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* 4. How can Hawthorne Gospel Church better serve in this area?

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* 5. If one or more of your family members are children, do they regularly attend class?

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* 6. What could be done to better serve and support your family?

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* 7. If your family would like to attend our church, what practical changes can we make?

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* 8. Outside of regular weekend services, please mark which ministries would better serve your family.

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* 9. To accomplish our goal, we need you. Would you please consider the following areas of ministry and mark any places where you feel God is calling you to serve and make a difference?

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* 10. How can we get in contact with you?

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