Information Survey : Toms River Seventh-Day Adventist Church Toms River NJ

Name

Address

EMAIL ADDRESS: It is important that we have your email, if you have one, so we can contact you with important information when appropriate.

Cell Phone: It is important that we have your cell phone # in order to contact you when needed. (If you do not have a cell phone, please enter 111-111-1111)

Home Phone: It is important that we have your home phone # especially if you don't have a cell phone. (If you do not have a home phone please enter 111-111-1111)

Emergency Contact Name: Please fill this out if you live alone and if needed we can contact your emergency contact if we feel something is wrong.

Emergency Contact's Cell Phone #

Emergency Contact's Home Phone #

Please type in the relationship of your Emergency Contact person to you? Example: Brother, Sister, Friend, etc.

Are you a Member or Non-Member/Friend/Visitor of the Church?

Member Non-Member/Friend/Visitor

If you are not a member of the Toms River SDA Church would you like to become a member?

YES NO NOT SURE I would like to discuss this with the Pastor

When the Church reopens under the mandated guidelines, will you be attending services at that time due to your health situation? This will help us decide if we will need more than one service to accommodate social distancing guidelines.

YES NO MAYBE

Do you have internet access in your home?

YES NO

To help us better serve you, please tell us which devices you have to view our services online. You can choose more than one.* Computer Tablet - ex: Ipad or Notepad, etc. Smartphone None of the Above

If you do not have access to any of the devices listed in the previous question, do you plan on purchasing one in the near future?

YES NO MAYBE NOT APPLICABLE

If you answered YES or MAYBE to the previous question, will you need help in setting up and using the device you plan or may plan on purchasing?

YES NO NOT SURE NOT APPLICABLE

Is there anything you want to inform the Church leadership about? You can fill out the area below with your comments, suggestions, etc.

Date Submitted

Information Survey

Please fill out the survey below (each person can fill out a separate survey) so the Church leadership can better serve you, when making plans to reopen!

This is a secure website so your information is secure.
Thank You for your participation. God's Blessings!

Please fill out the survey below (each person can fill out a separate survey) so the Church leadership can better serve you, when making plans to reopen!

This is a secure website so your information is secure.Thank You for your participation. God's Blessings!

This is a secure website so your information is secure.
Thank You for your participation. God's Blessings!