Bethlehem Worship Survey
Progress: 
 
1.
Gender
Male
Female
2.

Age

18 & under
19-24
25-34
35-44
45-59
60-69
70+
3.

What is your current marital status?

Single
Married
In a serious relationship
Divorced or separated
Widowed
4.

Age(s) of children in your home (check all that apply)

4 & under
5-12
13-17
18+
Empty nester within last few years
No Children