Name

First Name

Last Name

Your Church Experience (check all that apply)

Lots of Church Experience

Only on Holidays

Never Been to Church

Been Hurt in Church

Looking for a New Church

Were you greeted at the entrance?

Yes

No

N/A

Did you feel welcomed in the auditorium?

Yes

No

N/A

Were the Nursery and Kids Ministry team members friendly and helpful?

Yes

No

N/A

Would you come back to Restore Church?

Yes

No

Still thinking about it

Would you recommend Restore to friends and family?

Definitely

Probably

Not Sure

Probably Not

Definitely Not