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1. Participant Pseudonym (remember this name for post-course survey):

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2. Participating Church

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3. Age

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4. Sex

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5. Race (check all that apply)

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6. Denominational/Theological Tradition (check all that apply)

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7. Which of the following best describes your political identity?

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8. Why do you identify this way? What issues or attitudes most inform your answer?

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9. Political Party Affiliation

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10. How would you describe the political perspective of your family of origin?

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11. On a scale of 1-5 (1-strongly disagree, 5-strongly agree, please respond to the following questions.

  Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
Our country would be a better place if we passed Christian laws.
Christians should be involved in politics.
Churches should be involved in politics.
The politics of a local church is an important consideration for me when choosing a church to attend.
It is my Christian duty to vote.
If Jesus lived in America today, he would be a conservative.
If Jesus lived in America today, he would be a liberal/progressive.
If Jesus lived in America today, he would be non-partisan.
A Christian’s identity as a follower of Christ should be far more important than their identity as a Republican or Democrat.

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12. On a scale of 1-5 (1-not very important, 5-very important) how important are the following identities to you?

  I strongly reject this identity I do not think about this identity I admit this identity applies to me I embrace this identity This is very important to me
My family identity.
My rural or urban identity. (e.g. “I’m a city girl! I’m proud to be a farm boy!)
My state identity (i.e. Minnesotan, Californian, etc.)
My racial identity.
My denominational identity.
My "evangelical" identity. (as distinguished from Catholic, mainline, etc.)
My political identity. (e.g. Conservative, Liberal, etc.)
My Christian identity.

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13. How often does your church address political issues from the pulpit?

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14. Which sources of news/information/opinion do you most rely on?

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