Comments and Suggestions Questionnaire
Place an "X" in the brackets ( [ ] ).

Please fill out fully. All addresses become my PRIVATE
database and are NOT sold to anyone else.


Name __________________________
Address ___________________________
City ____________________,  State ___  ZIP ________
Phone# __________________________ (optional)
Birthday ___/___/___

Hobbies ___________________________________________________
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Denomination   [ ] Baptist
	       [ ] Assemblies of God
	       [ ] Four Square
	       [ ] Other ______________________________
	       [ ] Do not attend church

What did you like?
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What did you dislike?
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I would like to know more about becoming a Christian [ ]

Send response to:

Neal Stone
818 Burr RD #4
Olympia, WA 98501