Date _________________________                       Survey Given By _________________________


1. Do you believe abortion is acceptable?                                   (A) Yes     (B) No

2. Do you believe drinking alcohol is acceptable?                           (A) Yes     (B) No

3. Do you believe premarital sex is an acceptable lifestyle?                (A) Yes     (B) No

4. Do you believe homosexuality is acceptable?                              (A) Yes     (B) No

5. Do you believe Jesus Christ is the Son of God?                           (A) Yes     (B) No

6. Do you believe that the following things are agreeable to the teachings of Jesus?
                                                  A. Abortion               (A) Yes     (B) No
                                                  B. Drinking Alcohol       (A) Yes     (B) No
                                                  C. Premarital Sex         (A) Yes     (B) No
                                                  D. Homosexuality          (A) Yes     (B) No

7. Do you believe that the Bible is the Word of God?                        (A) Yes     (B) No

8. Do you believe that there is a Heaven?                                   (A) Yes     (B) No

9. Do you believe there is a Hell?                                          (A) Yes     (B) No

10. Do you believe there is a Devil?                                        (A) Yes     (B) No

11. How often do you read the Bible?                   (A) Daily  (B) Weekly  (C) Occasionally
                                                             (D) Hardly Ever  (E) Never

12. How often do you pray?                             (A) Daily  (B) Weekly  (C) Occasionally
                                                             (D) Hardly Ever  (E) Never

13. How often do you attend church?              (A) 1 Time A Week  (B) 2 Or More Times Weekly
                                                       (C) Occasionally  (D) Hardly Ever

14. Are you involved in a Bible study on campus?  If so, where? ______________________________

    If not, would you be willing to?   (A) Yes     (B) No

15. Is the Book of Romans in the Old Testament or New Testament?   (A) Old  (B) New

16. Who was Elijah? (A) Disciple  (B) King  (C) Greek Philosopher   (D) None of these

17. Name two people who walked on water in the Bible? ________________________________________

18. If you died today, do you know for sure where you would spend eternity?  (A) Yes     B) No

    If so, where?   (A) Heaven  (B) Hell  (C) Elsewhere

    How sure are you?   (0-100%) _______

19. What makes you think you will spend eternity there? ______________________________________

20. Is your relationship with Christ stronger or weaker since you have started

    college? ______________________________

21. What two university organizations occupy the most of your time? __________________________

    __________________________________________________________________________________________

Name _________________________________________ City _______________________ State ____________

Church Background ____________________________________________________________________________

Fr., So., Jr., Sr., or Grad. ________________ Major __________________________________________

Do you have any prayer requests? _____________________________________________________________

______________________________________________________________________________________________