Individual Survey and Poll

Individual Survey and Poll

Dear Friend,

Dear Friend,

Please take a few short minutes to complete this survey and return it to the person
who issued it to you.

Please take a few short minutes to complete this survey and return it to the person
who issued it to you.

1. Has anyone ever told you that God loves you and that He has a great plan for
your life?
mYes mNo

1. Has anyone ever told you that God loves you and that He has a great plan for
your life?
mYes mNo

2. If today were your last day here on earth, do you know for sure, beyond a
shadow of a doubt that you would go to Heaven?
mYes mNo

2. If today were your last day here on earth, do you know for sure, beyond a
shadow of a doubt that you would go to Heaven?
mYes mNo

3. If you answered, "yes" to question #2, is that because you are a good person
and/or because you attend church regularly?
mYes mNo

3. If you answered, "yes" to question #2, is that because you are a good person
and/or because you attend church regularly?
mYes mNo

4. Have you ever heard that the Holy Bible reads, "For all have sinned and come
short of the glory of God." And "For the wages of sin is death but the gift of God is
eternal life through Jesus Christ our Lord." And "Whosoever shall call upon the name
of the Lord shall be saved?"
mYes mNo

4. Have you ever heard that the Holy Bible reads, "For all have sinned and come
short of the glory of God." And "For the wages of sin is death but the gift of God is
eternal life through Jesus Christ our Lord." And "Whosoever shall call upon the name
of the Lord shall be saved?"
mYes mNo

5. Did you know that you are a "whosoever"?

5. Did you know that you are a "whosoever"?

mYes

mNo

mYes

mNo

Here's a quick prayer for you: Lord, bless each person who reads this with long and
healthy lives. Jesus, do a quick work in their heart and make Yourself so real to
them. If they have never called upon Your name, I pray that they will do so right
now.

Here's a quick prayer for you: Lord, bless each person who reads this with long and
healthy lives. Jesus, do a quick work in their heart and make Yourself so real to
them. If they have never called upon Your name, I pray that they will do so right
now.

If you would like to receive the gift that God has for you today, say this with your
heart and your lips out loud:

If you would like to receive the gift that God has for you today, say this with your
heart and your lips out loud:

Dear Lord Jesus, come into my heart. Forgive me of my sin. Set me free. Jesus,
thank You that You died for me. I believe that God raised You from the dead. Fill
me with the Holy Spirit, the peace of God, and the joy of the Lord. Give me a
passion to reach the lost, a hunger for the things of God, and a holy boldness to
preach the Gospel of Jesus Christ. I'm saved. I'm born-again. I'm forgiven and I'm
on my way to Heaven because I have Jesus in my heart. Thank You Jesus!

Dear Lord Jesus, come into my heart. Forgive me of my sin. Set me free. Jesus,
thank You that You died for me. I believe that God raised You from the dead. Fill
me with the Holy Spirit, the peace of God, and the joy of the Lord. Give me a
passion to reach the lost, a hunger for the things of God, and a holy boldness to
preach the Gospel of Jesus Christ. I'm saved. I'm born-again. I'm forgiven and I'm
on my way to Heaven because I have Jesus in my heart. Thank You Jesus!

When you asked Jesus to come into your heart and to forgive you, He heard you
and did so. All of your sins are now forgiven. Always remember to run to God and
NOT from God because He loves you and has a great plan for your life. That's VERY
good news.

When you asked Jesus to come into your heart and to forgive you, He heard you
and did so. All of your sins are now forgiven. Always remember to run to God and
NOT from God because He loves you and has a great plan for your life. That's VERY
good news.

6. Did you say the above prayer?

6. Did you say the above prayer?

mYes

mNo

mYes

mNo

My Name: ____________________________________________________________________
Address: ______________________________________________________________________
City: __________________________________ State: _____________ Zip: ________________
Phone: (
) ___________________________________

My Name: ____________________________________________________________________
Address: ______________________________________________________________________
City: __________________________________ State: _____________ Zip: ________________
Phone: (
) ___________________________________

Name of person who issued you the survey: _______________________________

Name of person who issued you the survey: _______________________________

Thank you for completing this survey.

Thank you for completing this survey.