JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Prophetic Witness Ministry
Initial Church Intake Survey
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Person completing this form
Your answer
Church Name
*
Your answer
Is your congregation interested in participating in social justice education and the sharing of available resources?
*
Yes
No
Maybe
Do you have a “Social Justice” (related) Ministry at your church? If yes, please share the name of the ministry,
*
Yes
No
Required
Name of Social Justice Ministry
Your answer
Social Justice Contact Person
Your answer
Email Address
Your answer
What social justice issues are important to your congregation? Please choose no more than 5
Affordable Housing
Black Lives Matter
Clean Water
Environmental Justice
Gentrification
Gun Violence/Community Violence
Health Care Reform
Immigration Reform
Livable Wages, Employment
Mass Incarceration
Police Reform
Pollution from Industrial Plants
Quality Education, Resources
Voting Rights
Other:
What justice issues do you think the ABCMC Region should address together? Check up to 3
Affordable Housing
Black Lives Matter
Clean Water
Environmental Justice
Gentrification
Gun Violence/Community Violence
Health Care Reform
Immigration Reform
Livable Wages, Employment
Mass Incarceration
Police Reform
Pollution from Industrial Plants
Quality Education, Resources
Voting Rights
Other:
Are there currently any justice issues impacting your community? What type of support would be helpful?
Your answer
List any justice organizations your church partners with.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
