Thank you for visiting Willow Chicago. We would love to know what you thought about our church. Please take a few minutes to tell us about your experience. We hope you enjoyed your time with us and would love for you to join us again.

1.	How satisfied were you with your experience at Willow Chicago?
	Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

2.	Why?

3.	How likely are you to attend another service at Willow Chicago?
	Very Likely Likely Neutral Unlikely Very Unlikely

4.	Why?

5.	What is your zip code?*

6.	Are you:
	under 18 18-24 25-34 35-54 over 55

7.	How did you hear about Willow Chicago?
	Friend    Internet Search    Print Ad    Mailer/Postcard    Willow Creek Church (other campus)    Other, please specify

8.	Is there any way we can be praying for you?

9.	Would you like to receive additional information about our church?
	YesNo

10.	Name

11.	Email