For the Future of Our Nation & Our Children
RequiredRequired Question(s)
Welcome to this survey in support of the campaign to double the number of Canberra Declaration signatures to 100,000 in one year. Your responses will help to achieve this goal.

This is our very first survey so please bear with us.  We have tried to keep the survey as simple and quick as possible. Your answers are confidential and will not be shared with any other individual or organisation beyond the Canberra Declaration.
 
These prizes are being offered in appreciation of your valuable help: 
- To all who complete the Survey: the possibility of seeing the new movie 'Freedom'
- To the three best ideas: $100 worth of donated books, Bibles and DVDs
- To another 25 creative ideas: A copy of 'Discovering Australia's Christian Heritage' by Col Stringer
 
Required 1.
What is your gender?
Male
Female
Required 2.
Which category describes your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
Required 3.
How long have you been receiving the Canberra Declaration Good News Update?
Less than 6 months
6 months to less than 1 year
1 year to less than 2 years
2 years to less than 3 years
3 to 4 years - I was one of the early signees
Required 4.
Are you on Facebook?
Yes
No
Required 5.
How often do you read the regular Good News Updates?
almost all of the time
most of the time
about half
less than half
almost never
  • Comment:

  • 500 characters left.
6.
How often do you respond to requests in Good News Updates to pray?
almost all of the time
most of the time
about half
less than half
almost never
7.
How often do you respond to requests in Good News Updates to send emails or write letters or put in submissions?
almost all of the time
most of the time
about half
less than half
almost never
8.

Help us do a better job serving you with the Canberra Declaration Good News Updates. Be honest. Please tell us whether you are most likely or very unlikely to agree with the following statements. Grade your answer accordingly. 

 Most Likely Somewhat Likely Middle Response Somewhat Unlikely Very Unlikely 
I agree - The Updates help me stay informed on important issues
I agree - The Updates help me take action on important issues
I agree - The Updates help me pray about important issues
I agree - The Updates are a bit too short
I agree - The Updates are a bit too long
  • Comment:

  • 500 characters left.
Required 9.
Do you have any suggestions for raising funds to help this campaign of the Canberra Declaration? If 'Yes' please write details in the comment box.
Yes
No
  • Comment:

  • 500 characters left.
Required 10.
Do you have any suggestions or creative ideas for increasing the number of signatures for the Canberra Declaration? If 'Yes' please write the details in the comment box.
Yes
No
  • Comment:

  • 500 characters left.
Required 11.
Which of these best describes your church affiliation? You can add further details of your denomination in the comments box.
Catholic
Protestant
Orthodox
Pentecostal
Evangelical
Christian but not affiliated to any local church
Agnostic
Belong to another world religion
Other  
  • Comment:

  • 500 characters left.
12.
Would you be willing to volunteer time helping in one of the following areas?
If there is something not on the list use other.
If there is more than one use the comments box.
sharing on social media
helping with website work
phoning
doing artwork or design
promoting at a conference
organising a meeting
entering data
helping with mailouts
writing letters, blogs or submissions
joining Canberra Declaration prayer team
helping with fundraising
helping with administration
Other  
  • Comment:

  • 500 characters left.
Required 13.
Please enter the information indicated below by completing each line.
If you do not have a work phone use a home one or a mobile.

First Name:
Last Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
Postal Code: