Clayton Pepper Center for Church Growth Studies
c/o Ohio Valley College
4501 College Parkway
Parkersburg, WV 26101 USA
(1) 304-485-7384 ext. 250

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PRIVACY POLICY: No personal information will be released with the results of the survey. Personal information will not be sold or otherwise provided for outside parties. Only survey workers will have information to do follow-up work.

DATE__________________________                     BS________

INTERVIEWER(S):__________________________          CB________

NAME____________________________________PHONE________________

ADDRESS______________________________________________________

1. Do you feel that churches are meeting the spiritual, emotional, physical and social needs of people today?____________________________________________________.
2. If you were asked by a church that really wanted to meet the needs of people, what would you say they need to do?____________________________________________.
3. What do you feel is the greatest need in our community?_______________________
   _________________________________________________________________.
4. Why do you think most people in this area do not attend worship services anywhere?
   _________________________________________________________________.
5. Do you have a Bible in your home?__________How many?______________ Which translations?___KJV___NKJV___ASV___NASV___NIV___OTHER___________
6. Are you____Catholic____Jewish____Protestant____(Affiliation)______________?

1. ___ ___ ___ Do you believe that all churches should teach the same message? (John 17:20-21)
2. ___ ___ ___ Do you believe the Bible comes from God? (2 Peter 1:20-2 1)
3. ___ ___ ___ Do you believe ALL the Bible is true? (2 Timothy 3:16-17)
4. ___ ___ ___ Do you believe that we need anything other than the Bible to teach us how to be saved from our sins? (James 1:2 1)
5. ___ ___ ___ Do you believe that Jesus Christ lived, died and came back from the dead? ( I Corinthians 15:1-4)
6. ___ ___ ___ Do you believe that Jesus is God? (Matt. 1:23; John 1: 1-2; 14)
7. ___ ___ ___ Do you believe that there is life after death? (Matt. 25:46)
8. ___ ___ ___ Do you believe that there is a heaven where people will be rewarded eternally? (Matt. 25:34)
9. ___ ___ ___ Do you believe that there is a hell where people will be punished eternally? (2 Thess. 1:7-9; Matt. 25:4 1)
10. ___ ___ ___ Do you believe that you will personally have to stand before God and give an answer for how you have lived in this life? (2 Cor. 5: 10)
11. ___ ___ ___ If you were to die today; do you know that you would be in a right relationship with God? (I John 5:13).
    If Question 11 is answered yes skip to Question 13.
12. ___ ___ ___ a. Would you like to know what God requires you to know and do to be in a right relationship with Him?
                         b. If you knew what to do to be in a right relationship with God would you do it?
13. ___ ___ ___ Do you feel that a better knowledge of the Bible would help you in any way?
14. ___ ___ ___ Would you like to receive the statistical results of this survey?

    [Jerry C. Dyer] Version 4.01

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