This survey is intended for adults with at least one child living at home.

We appreciate your willingness to answer questions about your family.

This survey should take from three to seven minutes to complete.

Information will only be reported at the church, association, or state level. All individual responses are completely anonymous.

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1. What is the complete name of your church? (For Example - If First Baptist Church, please do not abbreviate).

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2. What is the city of your church?

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3. Our church employs: (Check all that apply)

Questions 4-20 Copyright C Timothy Jones, Family Ministry Field Guide (Indianapolis, Ind: Weslyan Publishing House, 2011). Used by permission.

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4. Describe how often you attend any worship service at your church.

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