Please respond to the following questions about yourself, your church, and your experience with faith so far. There are no right or wrong answers, and your responses will be kept confidential. Your leaders will not see your responses, and we will not use your name in any way publicly.

*1.Church Name:(Required.)

2.City, State:

3.First Name:

4.Are you a young adult?

Yes

No

Demographic Questions

5.What is your date of birth? (format: MM/DD/YYYY)

6.Please specify your gender:

1 Female

2 Male

7.Please specify your ethnicity:

1 Multiracial or Multiethnic

2 American Indian or Alaskan Native

3 Asian

4 Black or African American

5 Latino/Hispanic

6 Middle Eastern or North African

7 Native Hawaiian or Pacific Islander

8 White

Other (please specify)