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Which of the following best describes your marital status?
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Anniversary Date, (mm/dd/yyyy):
How many children under the age of 18 are currently living in your household? Number of children:


Please indicate your denomination: Denomination:
Please indicate your household income: Household Income:

How would you describe yourself? Ethnicity:

Do you serve in a leadership role at your church? (Please check all that apply)
Pastor
Advisory (Elder, Deacon, Trustee, etc.)
Administrative
Outreach
Children's Ministry
Youth Ministry
College Ministry
Music Ministry
Small Group
Missions
None

Which products do you shop for most at Family Christian? (Please check all that apply)
Bibles
Books
Music
Kids
Video
Gifts and Home Decor
Cards

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