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* 1. I am a ...

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* 2. Did you experience, observe, or hear of any problems within the assembly? Check all that apply and give scripture (if possible). (Rom 12, 1Co 12 &13, Eph 4:11-16)

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* 3. Did you inform one or more members of these problems or sinful activities?

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* 4. Was the problem(s) of spiritual concern addressed or handled according to scripture and resolved

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* 5. Did you have any problems with Non-Scriptural issues or personal matters of opinion you would like us to address? Check all that apply.

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* 6. If you were able to attend services next week, would you return? 

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* 7. Enter other Questions, Comments, Concerns or Suggestions you have. Please provide your contact  information if you want to be contacted.

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