Family Background Survey

Read Your Bible. Make it Visible.

Please Reflect for a Moment Before Answering

* Indicates required field

Did you live in your primary residence with your father? *

YES NO

You can give context to his absence if you'd like *

Did your father indentify as a Christian? *

YES NO

Did your father attend church regularly? *

Yes No

Did your father read the Bible to you and/or with you at home regularly? *

YES NO

Was your mother your father's only wife? *

Yes No My parents were never married

You can give context to why he had multiple wives if you'd like *

Was her father a Christ-centered man? *

Yes No

Did you have any children outside of marriage? *

YES NO

Current Marital Status *

Single Married Divorced Seperated Widowed Domestic Partner

Have you ever been divorced? *

Yes No

Have you ever struggled with an addiction? *

YES NO

What's your gender? *

Man Woman

Do you identify as a gender other than what you were assigned at birth? *

Yes No

Which describes your race? *

Black or African American White / Caucasian Asian Hispanic / Latino / Spanish Other (please specify below)

. *

Submit