Bless Buncombe Initiative
Thank you for taking the time to invest your life in positively impacting our region.
1. How did you hear about us?
Select one answer
*
Social Media
Website
Friend
Event or Sign
Church
Other
How Would You like to use your Passion & Skills to Bless Buncombe?
*
Please Select
Join The Prayer Team
Partner Financially
Marketing & Social Media
Church Relations
Community Connect Ctr.
Business Relations
Youth Entrepreneurship
Single Mom Program
Home Repairs -
Car Repairs
Lawn Care
Use My Passion/Skills
Other
Make a Positive Impact
What is your passion?
*
Please share what you are most passionate about and how you would like to bless others with it.
What Are The Biggest Problems in our County?
*
Gun Crime & Violence
High Taxes
Homeless Crisis
Fatherless Youth
School Crisis
Housing Cost
Race Issues
Other
Do You Believe Churches are making a positive Impact in the community?
*
Please Select
Yes
No
They are Closed
Too Far From Me
Other
Do You Believe Churches are Essential to the Community?
*
Please Select
Yes
No
Would you attend a Church if they offered Relative Programs and Services to you and your family?
*
Please Select
Yes
No
Not Sure
No Opinion
3. Your Contact Information
Your Name
*
First Name
Last Name
Your E-mail Address
*
example@example.com
Cell Phone Number
*
-
Area Code
Phone Number
How Old Are You?
*
Name of the city or town where you live in Buncombe?
*
Zip Code
Religious Affiliation
*
Christian
Baptist
Catholic
Jewish
Presbyterian
Lutheran
Methodist
Other
How Do You Identify yourself?
*
Please Select
Male at Birth
Female at Birth
Other
Gay
Transgender
They
Status
*
Single
Married
Widow (er)
Single Mom
Single Dad
Other
Thanks for Investing Your Time to make a Positive Impact. We Pray Blessings over you & Your Family.
Send Response
Should be Empty: