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* 1. Marital Status

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* 3. Location

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* 4. Do you have any children living at home with you?

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* 6. Do your children participate in Kid's Church or Student Ministry?

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* 7. How long have you been attending i5 CITY?

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* 9. Has this pandemic had an effect on your employment status?

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* 10. Are you connected to an online group or serve team?

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* 11. Do you feel connected to our church?

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* 12. Would you be interested in regular motivational/inspirational videos on-demand created by i5 CITY?

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* 13. We want to resume in-person services as soon as we can safely gather. At what point would you feel comfortable attending a service inside of our building?

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* 14. Are you experiencing high levels of fear or anxiety during this time?

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* 15. Are you experiencing higher-than-usual depression, sadness, or feelings of futility during this time?

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* 16. Feel free to share any additional comments in the space below.

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* 17. What are your greatest prayer needs right now?

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* 18. Would you like a pastor or someone from our team to call you for prayer?

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* 19. Please fill in your contact information to receive a call for prayer.

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