Basic HTML Version
Fill in NOW, while it is on your mind, and return in the
enclosed self-addressed reply envelope.
With love, in Jesus' name,
Herbert W. Armstrong
Q U E S T I O N N A I R E
TO BE FILLED OUT BY ONE MEMBER OF EACH FAMILY
1. How many members of your family are baptized members? _________
Are,husband and wife, both, in the Church? _________________
Give ages of children: Boys ____________; Girls ____________
2. Do you attend a local Church regularly?____; Occasionally?_____
How far do you live from nearest Church? ___________________
3. Are you single? Man ________. Woman ________. Widower ________.
Widow ________. Husband of non-member wife? ________; if so,
is she hostile? ________; Interested? ________. Wife of non-
member husband? ________; if so, is he hostile? ___________;
Interested? _________.
4. Do you live in a city of over 100,000?___; suburbs of city?____
smaller city? _______; small town? _______; rural? ________
5. Are you unemployed?_________. How long have you been?_________.
Is it because of disability?___________; or unable to obtain
employment:________________________________________________.
6. Are you on salary or wages?__________; Commissions?___________.
Self employed?___________.
7. Do you own a business?____________. What kind?________________.
Are you a professional man or woman?______. What profession?
___________________. Executive or department manager?_______
Salesman?______. Office work?______. Factory worker?________
Other form of labor________________. Is your net taxable in-