Unlimited Possibilities

Note: This questionnaire is completely optional.

We respect your privacy. Your membership at Second Calvary Baptist Church will not be affected if you choose not to complete this form or if you leave any questions unanswered, including name and contact information. Anonymous responses are welcome and will still help Second Calvary Baptist Church better understand and serve the needs of our congregation.

First name

Last name

Email

Phone

I am

A child with disabilities (10-17 yrs old)

An adult (18-35 yrs old) with disabilities

An adult (36+ yrs old) with disabilities

A parent/guardian of a child with disabilities

A parent/guardian of an adult with disabilities

How does your disability affect your day-to-day life (at home, work/school, or in the community)?

In the following section, please indicate how useful each of these accessibility aids would be for you or your loved one at Second Calvary Baptist Church:

Unhelpful, would never use
Slightly helpful, would rarely use
Moderately helpful, would use often
Highly helpful, would use often
Necessary, required for participation

What else would help you or your loved one participate in worship, fellowship, and ministry at Second Calvary Baptist Church?

unlimited possibilities

Embracing Diversity | Celebrating Humanity