GSVE Community Survey Question Title * 1. Please enter your contact information Name Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 2. Gender Male Female Question Title * 3. What is your preferred method of contact? Phone Email Postal Service Question Title * 4. Have you gone on a Emmaus Walk or Chrysalis Flight? Yes No If Yes, please give the community and walk or flight # Question Title * 5. If you have served on an Emmaus team(s) please check all the positions you have held. Assistant Table Leader Table Leader ALD Log Tech Log Music Director Assistant Music Director Board Rep LD Shared Clergy Talk Live in ASD Live In SD Question Title * 6. If you have served on a Chrysalis team(s) please check all the positions you have held. Agape Prayer Chapel Coordinator Youth Table Leader Table Leader ALD Log Tech Log Music Director Assistant Music Director Board Rep LD Shared Clergy Talk Live in ASD Live In SD Question Title * 7. Are you capable of leading worship? No Singer Musician Both Question Title * 8. Would you be interested in serving on a team in the future? Yes No Question Title * 9. Would you be interested in serving at gatherings? No Lead Worship Share Special Music Share Fourth Day Talk Help with Communion Question Title * 10. Are you interested in serving on a committee? If so, check all that may apply. No Outreach (for Gatherings) Registration (at the beginning of walks) Housekeeping (for gatherings and before and after walk weekends) Question Title * 11. Are you active in a share group? Yes No If YES, please list the name of your share group and the city you meet in. Question Title * 12. Do you regularly attend church? Yes No If Yes, Where? Done
