Bible Survey
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1. Do you believe there is a God?
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Please select one option.
Yes
No
2. Do you believe that a personal relationship with God can improve a person’s life?
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Please select one option.
Yes
No
3. Do you believe that you can know God in some way?
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Please select one option.
Yes
No
4. Have you ever made efforts to know God better?
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Please select one option.
Yes
No
5. Do you believe the BIBLE was given to us by God?
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Please select one option.
Yes
No
6. Do you think if a person understood the BIBLE, they could know God better?
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Yes
No
7. Do you think God expects us to live by the BIBLE today?
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Yes
No
8. Do you feel the BIBLE reveals events that are happening today?
*
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Yes
No
9. Have you ever heard about the return of Christ?
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Please select one option.
Yes
No
10. When the Lord returns, do you feel you will be among the group He takes with Him?
*
Please select one option.
Yes
No
11. Would you be interested in studying the BIBLE in your home to help you understand it better?
*
Please select one option.
Yes
No
12. If not, would you be interested in being sent a free BIBLE study on video?
*
Please select one option.
Yes
No
If YES, what day and time is best?
Day of the week:
Please select one option.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Select Option
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Time:
Please select one option.
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
3:30 PM
4:00 PM
4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
Select Option
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
3:30 PM
4:00 PM
4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
Remarks:
Name
*
Email
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Phone
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Address
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
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NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
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