BASES Family Life Questionnaire

BASES Family Life Questionnaire

BASES Family Ministry is striving to build a program for families in accordance with the needs and interests of our families and community. Please take a few minutes to respond to the following items. Your response is important to us!
Tell us about your family and household:*

Single: Live AloneSingle: Children in HomeCouple: No ChildrenTwo parents: Children in HomeTwo parents: Adult Child in HomeStepfamily: Children in HomeGrandparent raising grandchildrenOther
Other (Family and Household):*
Tell us about your interests and concerns: Which of the following would you be interested in attending if offered as workshops, seminars, or small groups.*

Faith Growing in MarriageFamily WorshipFamily Communication SkillsCaring for Aging ParentsSkills for ParentingStepparent SkillsBlended FamiliesEngaged Enrichment and TrainingMarriage EnrichmentMarried AgainMarried but Separated by Distance (Armed Forces, School, Prison)Divorce Recovery for ChildrenDivorce Recovery for YouthDivorce Recovery for AdultsFinancial PlanningFamily Survival after The Loss of a Family MemberSexuality: Talking with ChildrenSexuality: Issues for AdultsTwelve Step ProgramDrug or Alcohol AbuseRespite from Care for Loved One
Tell us what will work best for you in meetingthese needs:*

Small Groups for CouplesSmall Groups for SinglesShort-Term Study Groups on WednesdaysStudy Group on an evening other than WednesdayStudy Group during the dayMarriage GroupTopics covered as part of Bible Class
What kinds of congregational activities would beimportant to you and your family? List your suggestions here:*
Tell us where you have skills in leading in any of the topics identified:*
Are you interested in leading a group on this topic?*
Tell us other interests and concerns you have not mentioned above that you would like to see the church offer to families: *

How family-friendly would you say our congregation is? *

	Poor	Average	Good	Excellent
Family Friendliness

What could we do to improve? *
Name:

First NameLast Name
Email:*
example@example.com
Should be Empty: