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Text File  |  1995-03-27  |  2KB  |  48 lines
  1. Comments and Suggestions Questionnaire
  2. Place an "X" in the brackets ( [ ] ).
  3.  
  4. Please fill out fully. All addresses become my PRIVATE
  5. database and are NOT sold to anyone else.
  6.  
  7.  
  8. Name __________________________
  9. Address ___________________________
  10. City ____________________,  State ___  ZIP ________
  11. Phone# __________________________ (optional)
  12. Birthday ___/___/___
  13.  
  14. Hobbies ___________________________________________________
  15.     ___________________________________________________
  16.     ___________________________________________________
  17.     ___________________________________________________
  18.     ___________________________________________________
  19.  
  20. Denomination   [ ] Baptist
  21.            [ ] Assemblies of God
  22.            [ ] Four Square
  23.            [ ] Other ______________________________
  24.            [ ] Do not attend church
  25.  
  26. What did you like?
  27.     ___________________________________________________
  28.     ___________________________________________________
  29.     ___________________________________________________
  30.     ___________________________________________________
  31.     ___________________________________________________
  32.  
  33. What did you dislike?
  34.     ___________________________________________________
  35.     ___________________________________________________
  36.     ___________________________________________________
  37.     ___________________________________________________
  38.     ___________________________________________________
  39.  
  40. I would like to know more about becoming a Christian [ ]
  41.  
  42. Send response to:
  43.  
  44. Neal Stone
  45. 818 Burr RD #4
  46. Olympia, WA 98501
  47.  
  48.