Thank you for your interest in Shiloh's Couples Ministry. We want to know the best way we can serve you. Please answer the questions below to the best of your ability.

* 1. What do you hope to gain from the Couples Ministry? (Check all that apply)

* 2. What day/time would you be available to participate in the Couples Ministry events, classes, etc.?
(Check all that apply)

* 3. How often would you like to participate in the Couples Ministry events, classes, etc.?

* 4. Which components of the Couples Ministry are of interest to you? (Check all that apply)

* 5. How would you like to be contacted and/or receive information about the Couples Ministry classes,
events, etc.? (Check all that apply)

* 6. Do you have any concerns that would prevent you from participating in the Couples Ministry?
(Please be specific)

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