EmailMe Form - The Salvation Accuracy Test

Name *
First Last
1. On a scale of 1-10 how sure are you that if you died right now you would go to heaven? *

not sure 2 3 4 5 6 7 8 9 very sure

1 2 3 4 5 6 7 8 9 10
2. If you died and stood before God and He asked you why should he allow you into heaven what would you say? *
3. How would you define the term Lord? *
4. Name two things that PROVES you are Saved *
5. Did Jesus rise from the dead physically or spiritually? *
Physically
Spiritually
Both
6. Can a person be saved yet refused to be baptized? *
Yes
No
7. Are You NATURALLY a GOOD person? *
Yes
No
8. Do you feel that you have done anything bad enough to deserve hell? *
Yes
No
9. Have you attended Church in the last 3 weeks? *
Yes
No
Name of Church
10. Please enter your email *

Confirm
Phone
### - ### - ####
Address

Street Address City State / Province / Region Postal / Zip Code Country / Region
enter email of the person that referred you
How can we help you
Looking for a new Church
Need to be baptized/rebaptized
Need Prayer

	not sure	2	3	4	5	6	7	8	9	very sure
	1	2	3	4	5	6	7	8	9	10

Evaluate the following statements.

	Strongly Disagree	Disagree	Agree	Strongly Agree
I found this survey helpful	1	2	3	4
I will share this with at least 2 others	1	2	3	4
I would like to become a Salvation Tech and work with this ministry	1	2	3	4