Midwestern Evangelistic Teams

Religious Questionnaire I
1. Are you the member of any religious group? 9. To what religious writings do you adhere to, if any?
Yes _________________________________________ Bible _______________________________________
No _________________________________________ Koran _______________________________________
Used to be ______________________________________ Torah _______________________________________
Joining ______________________________________ Other ___________ ___________ ___________ ___________ ___________
2. What religious group is this? If not, were you brought up in the beliefs of a religious 10. How often do you refer to this religious book?
group? Daily _______________________________________
Christian _______________________________________ Weekly _______________________________________
Islam _______________________________________ Monthly _______________________________________
Hindu _______________________________________ Annually _______________________________________
Individual _______________________________________ 11. How do your religious beliefs influence the way you live?
Other ___________ ___________ ___________ ___________ ___________ In every way ____________________________________
___________ ___________ ___________ ___________ ___________ In most things ____________________________________
3. Where you brought up in this religion? If not, skip. In some things ____________________________________
Yes _________________________________________ Very little _______________________________________
No _________________________________________ No at all _______________________________________
4. At what period of your life did you become interested in this religion? If not, at what 12. Do you seek to tell your acquaintances about your religious beliefs?
period did you become disinterested? Never _______________________________________
Childhood _____________________________________ Seldom _______________________________________
Adolescence _____________________________________ Sometimes ______________________________________
Early adulthood ___________________________________ Regularly _______________________________________
Middle life _____________________________________ 13. Do you feel that your religion is the only true religion?
Later life _____________________________________ Yes _________________________________________
5. Do you ever participate in religious services? No _________________________________________
Yes _________________________________________ 14. Are you certain that if you died tonight you would achieve "salvation" in your religion?
No _________________________________________ Yes _________________________________________
6. How often do you participate in religious services? Hope so _______________________________________
Daily ________________________________________ No _________________________________________
Weekly ________________________________________ 15. If you stood before the Supreme Being and He asked you, "Why should I let you into
Monthly _______________________________________ my heaven?" what would you answer?
Annually _______________________________________ Lived a good life ___________________________________
7. How far do you travel to these religious services? Did my best ___________________________________
1-5 miles ______________________________________ Don't know ___________________________________
5-10 miles ______________________________________ I believe _______________________________________
10-20 miles ______________________________________ Other ___________ ___________ ___________ ___________ ___________
20 or more miles ___________________________________ 16. Can I show you a pamphlet which may assist you in your religious journey?
8. If you had children, would you rear them in this religion? Yes _________________________________________
Yes _________________________________________ No _________________________________________
No _________________________________________ Those not wanting to complete questionnaire ______________________
Other ___________ ___________ ___________ ___________ ___________
_ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
___________ ___________ ___________ ___________ ___________

11/11/2017