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Vision Church Los Angeles New Partnership Questionnaire
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1.
What is you contact information?
(Required.)
Name
Address
City
State
Zip
Email Address
Phone Number
*
2.
What is your race/ ethnicity? (Please select all that apply)
(Required.)
Black or African American
Hispanic or Latino
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
White or Caucasian
Another race/ ethnicity (please specify)
*
3.
When is your birthday?
(Required.)
MM/DD/YYYY
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
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4.
What is your gender identity?
(Required.)
Male
Female
Transgender woman
Transgender man
Another identity (please specify):
*
5.
How did you hear about Vision Church Los Angeles?
(Required.)
Facebook
Instagram
YouTube
Family or Friend
Vision Nation
Other (please specify)
*
6.
What was your last ministry of affiliation, if any?
(Required.)
*
7.
My interests include (please select all that apply):
(Required.)
Music
Arts and culture
Social justice and education
Community building
Advertising/ Marketing/ Public relations
Technology and media
Finance and administration
Something else (please specify)
*
8.
Would you recommend a friend or family member to Vision LA?
(Required.)
Yes
No
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9.
What is your preferred mode of contact?
(Required.)
Text message
Email
Phone call
Any of these are great!
Other (please specify)
*
10.
What is something you look forward to experiencing with Vision LA or anything else you would like to share?
(Required.)
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