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					Better Life TV Community Survey ________(date)                              Better Life TV Community Survey ________(date)
Hi! I’m ________ and this is _______.                                       Hi! I’m ________ and this is _______.

1. We’re here on behalf of Better Life TV Network and we’re                 1. We’re here on behalf of Better Life TV Network and we’re
wondering if you receive our signal at home? Yes ____ No _____              wondering if you receive our signal at home? Yes ____ No _____

        [If yes] Do you watch it? Yes ___     No ___                                [If yes] Do you watch it? Yes ___     No ___

(Better Life is carried on Direct TV Channel 30, Dish Network, and          (Better Life is carried on Direct TV Channel 30, Dish Network, and
Northland Cable Channel 96. To get #96, you have to select manually.        Northland Cable Channel 96. To get #96, you have to select manually.

Better Life TV is a Christian network that carries inspirational programs   Better Life TV is a Christian network that carries inspirational programs
for people of all ages and backgrounds.                                     for people of all ages and backgrounds.

2. We are members of the Mt. Shasta Seventh-day Adventist Church.           2. We are members of the Mt. Shasta Seventh-day Adventist Church.
Our church sponsors Better Life television in this area. We also offer      Our church sponsors Better Life television in this area. We also offer
free local seminars on health, family, and world events. Do any of          free local seminars on health, family, and world events. Do any of
these topics interest you?                                                  these topics interest you?

Health: ____ smoking/alcohol/drug cessation                                 Health: ____ smoking/alcohol/drug cessation
        ____ chronic disease (diabetes, HD, cancer, HBP)                            ____ chronic disease (diabetes, HD, cancer, HBP)
        ____ healthful/vegetarian cooking                                           ____ healthful/vegetarian cooking
        ____ weight loss                                                            ____ weight loss

Family: ____ raising children        ___ loss through death                 Family: ____ raising children        ___ loss through death
        ____ marriage                ___ divorce                                    ____ marriage                ___ divorce
        ____ aging parents                                                          ____ aging parents

World ____ economy/job market             ___ terrorism                     World ____ economy/job market             ___ terrorism
events: ____ natural disasters            ___ morality                      events: ____ natural disasters            ___ morality

3. We believe the Bible offers hope for the future and is a sure guide      3. We believe the Bible offers hope for the future and is a sure guide
for issues we face. Would you like to receive free Bible studies? _____     for issues we face. Would you like to receive free Bible studies? _____
         (Do you need a Bible? Yes ___       No___ )                                 (Do you need a Bible? Yes ___       No___ )

4. May we pray about something specific for you? ________________           4. May we pray about something specific for you? ________________

________________________________________________________                    ________________________________________________________

5. Would you like to receive information about future seminars in our       5. Would you like to receive information about future seminars in our
area or a free KBLN program guide? (circle one) Yes____ No ____             area or a free KBLN program guide? (circle one) Yes____ No ____

Name ___________________________________________________                    Name ___________________________________________________

Address _________________________________________________                   Address _________________________________________________

City _________ Phone _______________ Email _________________                City _________ Phone _______________ Email _________________

				
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posted:7/6/2010
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