Door-to-Door Religious Outreach Survey Form
Thank you for participating in the Door-to-Door Religious Outreach Survey Form. Your responses will help us understand your interests and preferences.
First Name
What is your age group?
Please Select
Under 18
18–29
30–49
50–64
65 or older
Prefer not to say
Which of the following best describes your current religious affiliation?
Christian
Muslim
Jewish
Hindu
Buddhist
None
Other
Have you previously been contacted by our outreach team?
Yes
No
Not sure
How interested are you in learning more about our beliefs or activities?
1
2
3
4
5
Which topics would you be interested in discussing further? (Select all that apply)
Faith and beliefs
Community events
Volunteer opportunities
Youth programs
Other
What is your preferred method for future contact?
In-person visit
Phone call
Email
No further contact
How welcome did you feel during our visit?
Not at all
1
2
3
4
Very welcome
5
1 is Not at all, 5 is Very welcome
Would you be open to a future visit from our outreach team?
Yes
No
Maybe
Any additional comments or feedback?
Submit
Should be Empty: