Visitor Survey
BRCC Visitor Survey Form
We are glad you are visiting us at Buckingham Road Church of Christ! We want to extend to you warmth, love and hospitality.
How did you hear about Buckingham Road Church of Christ?
*
Please select one option.
Friend/Family
Social Media: Facebood
Social Media: Twitter
Social Media: YouTube
Flyer/Advertisement
Other
Select Option
Friend/Family
Social Media: Facebood
Social Media: Twitter
Social Media: YouTube
Flyer/Advertisement
Other
Was this your first time visiting with us?
*
Please select one option.
Yes
No
Select Option
Yes
No
Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Email
*
This address will receive a confirmation email
Phone
Do you have children?
Please select one option.
Yes
No
Select Option
Yes
No
What Are You Children School Age?
Please select all that apply.
Elementary
Middle School
Jr/High School
No Children At Home
Was your experience with us:
Please select one option.
Spiritually Uplifting
Biblically Sound
Friendly and Welcoming
All The Above
Select Option
Spiritually Uplifting
Biblically Sound
Friendly and Welcoming
All The Above
Were you greeted at the door?
Please select one option.
Yes
No
Select Option
Yes
No
Did you receive one of our welcome bags?
*
Please select one option.
Yes
No
Select Option
Yes
No
Do you have any prayer requests?
Would you like more information about Buckingham Road Church of Christ?
*
Please select one option.
Yes
No
Select Option
Yes
No
May we contact you about upcoming events by:
Please select one option.
Email
Text
Home Visit
All The Above
Select Option
Email
Text
Home Visit
All The Above
Is there anything we can do to make the experience better for visitors?
Submit
Description
BRCC Visitor Survey Form
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