Name *

First Name

Last Name

Phone

(###)

###

####

How did you learn about Chinatown Peace Church? *

Check all that apply

Friend or family

Walked by the church

Attended in the past

Promotional material (ie. flyer, Facebook, etc.)

Other (Please specify in next question)

What is your experience with Christian churches? *

I have little or no experience

I have some experience

I am very familiar with Christian churches

I have had a negative church experience in the past

I come from a different faith background

What are you looking for at Chinatown Peace Church? *

Check all that apply

To learn more about Jesus/Christianity

A group of people to share life with

New friends

Bible knowledge

Other (Please specify in next question)

Please indicate your current life stage. *

Youth

Young adult

Young couple

Adult

Couple

Young family

Family

Empty nester

Please indicate your preferred language. *

English

Cantonese

How would you like us to respond? *

General information by phone

General information by email

Contact from pastor

No response recessary