Skip to main content
Close Search
search
0
Menu
Home
Watch
About DABC
Our History
Church Staff
Galleries
Connect
Ministries
Sunday School & Bible Study
Prayer Request
Contact Us
Events
Our Partners Events
Resources
Assistance Request
Food Giveaways
Classes
Funeral Services
Baptism
Speaking Engagements
Music Lessons Sign-Up
Volunteer With Us
ABCOFLASH.org
Giving
facebook
youtube
instagram
phone
email
search
0
was successfully added to your cart.
Church Raffle Questionnaire
Del Aire Baptist Church will provide a raffle ticket to those fill out the form and present the submission message to our staff. We will only give 1 per family.
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Personal Information
of you Information
Full Name
Your Age
Email Address
Phone Number
What is your age?
*
18–24
25–34
35–44
45–54
55–64
65 or older
How would you describe your race or ethnicity? (Select all that apply)
*
Asian / Asian American
Black / African American
Hispanic / Latino / Latina / Latinx
Middle Eastern / North African
Native American / Alaska Native
Native Hawaiian / Pacific Islander
White
Prefer not to say
How do you identify your gender?
*
Female
Male
Non-binary
Prefer not to say
What is the highest level of education you have completed?
*
Less than high school diploma
High school diploma or equivalent (GED)
Some college, no degree
Associate degree (AA / AS)
Bachelor's degree (BA / BS)
Higher Education (MA / MS / MBA / PhD / JD / MD)
Prefer not to say
Survey Information
Please Answer To The Best Of Your Ability
How long have you lived in this community?
*
1 year
1–5 years
5–10 years
10+ years
What religious family do you belong to or identify yourself most close to?
*
Christian
Catholic
Buddhist
Hindu
Muslim
Jewish
Sikh
No Religion
Another Religion
I am not religious
I am Spiritual
Do you consider yourself to be committed to your religious teachings?
*
Yes
No
Not Sure
N/A
How many times do you attend religious services or ceremonies at your place of worship?
*
Never
Less than once a year
Once or twice a year
Several times a year
Once a month
2-3 times a month
About once a week
Several times a week
How far is your current place of worship from your home?
*
1-5 minutes
6-15 minutes
16-30 minutes
31 – 45 minutes
Over 45 minutes
Don’t know
How often do you turn to your religion to help you deal with problems in your life?
*
Never
Rarely
Sometimes
Often
Always
Which of the following do you feel religious centers/churches should assist with? (Select up to 3)
*
Food Security (e.g., food pantry, community meals, meal delivery)
Family & Youth Support (e.g., after-school programs, childcare, tutoring, youth activities)
Senior Care & Outreach (e.g., home visits, tech help for seniors)
Housing & Homelessness Relief (e.g., temporary shelter support, housing supplies, emergency aid)
Mental Health & Wellness (e.g., support groups, counseling services, addiction recovery)
Employment & Financial Literacy (e.g., job training, resume help, budgeting workshops)
Community Connection & Events (e.g., neighborhood gatherings, sports leagues, cultural events)
What specific challenges are you or people in your neighborhood facing right now?
What types of practical assistance would be most valuable to you/your family? (Check all that apply)
*
Direct relief (groceries, clothing drives, emergency financial assistance)
Education & Skill Building (workshops, ESL classes, financial literacy)
Emotional & Spiritual Care (support groups, prayer requests, grief counseling)
Space & Resources (meeting rooms for local groups, public internet access, community garden)
How can the church best coordinate and communicate these resources to the neighborhood?
*
Social media / online updates
Email newsletter
Physical flyers / bulletin boards in local community spots
Word of mouth / door-to-door outreach
Additional Comments or Ideas
Submit
Close Menu
Home
Watch
About DABC
Our History
Church Staff
Galleries
Connect
Ministries
Sunday School & Bible Study
Prayer Request
Contact Us
Events
Our Partners Events
Resources
Assistance Request
Food Giveaways
Classes
Funeral Services
Baptism
Speaking Engagements
Music Lessons Sign-Up
Volunteer With Us
ABCOFLASH.org
Giving
facebook
youtube
instagram
phone
email