Name

Your E-mail address

Tell Me About Yourself

Gender: Male Female

What is your age? (check one):

0-6

7-12

13-18

19-29

30-45

46-64

65 +

How long have you been in Canada? (check one):

less than 3 years

3 to 5 years

6 to 10 years

over 10 years

How long have you been attending VCLC? (check one):

less than 3 years

3 to 5 years

6 to 7 years

over 7 years

Are you a member of VCLC? Yes No

How often do you attend Chinese worship at VCLC? (check one):

	3 or more times a month		2 times a month		once a month		every 2 month
	3 - 4 times a year		1 - 2 times a year		never

How often do you attend English worship at VCLC? (check one):

	3 or more times a month		2 times a month		once a month		every 2 month
	3 - 4 times a year		1 - 2 times a year		never

What category best describes your occupation? (check one):

	Business		Clerical		Laborer		Student		Self-employed
	Professional		Homemaker		Unemployed		Other

hat category best describes your Education? (check one):

Elementary

High School

college/University

Graduated School

Where do you live? (check one):

	Burnaby		Coquitlam		North Shore		Richmond
	Surrey/Delta		Vancouver		Other

Additional Information
Select and type over this text to enter your message here.