Manufacturers of God would like to thank you for your belief and patronage of our product. In order to better serve your needs, we ask that you take a few moments to answer the following questions.

Please keep in mind that your responses will be kept completely confidential and that you need not disclose your name or address unless you prefer a direct response to comments or suggestions.

1. How did you find out about God?
__ Newspaper
__ Television
__ Tabloid
__ Word of mouth
__ Bible
__ Koran
__ Torah
__ Divine Inspiration
__ Near Death Experience
__ Communist Manifesto
__ Bhagavad-Gita
__ Burning Shrubbery
__ Other sources (specify): _____________

2. Which model God did you acquire?
__ Father, Son & Holy Ghost Triplet
__ Jehova
__ Yoweh
__ Jesus
__ Alah
__ Satan
__ God
__ G_d
__ None of the above, I was taken in by a false god

3. Did your God come to you undamaged, with all parts in good working order and with no obvious breakage or missing attributes?
__ Yes __ No

If no, please describe the problems you initially encountered here: ____

4. What factors were relevant in your decision to acquire a god? Please check all that apply.
__ Indoctrinated by parents
__ Indoctrinated by society
__ Imaginary friend grew up
__ Wanted to meet girls/boys
__ Wanted to piss off parents
__ Desperate need for certainty
__ Need to feel Morally Superior
__ Needed a reason to live
__ Needed focus in who to despise
__ Hate to think for myself
__ Fear of murder by a missionary
__ Needed a day away from work
__ Like Organ Music
__ My shrubbery caught fire and told me to do it

5. Have you ever worshipped a God before? Is so, which false god were you fooled by? Please check all that apply.
__ Odin
__ Cthulhu
__ Zeus
__ The Almighty Dollar
__ Apollo
__ Left Wing Liberalism
__ Ra
__ Barney T.B.P.D.
__ The Great Spirit
__ The Great Pumpkin
__ The Sun
__ The Moon
__ A burning cabbage
__ The Bomb
__ Other: ________________

6. Are you currently using any other source of inspiration in addition to God? Please check all that apply.
__ Tarot
__ Lottery
__ Astrology
__ Television
__ Fortune cookies
__ Advice columnist
__ Psychic Friends Network
__ Dianetics
__ Palmistry
__ Playboy / Playgirl
__ Self-help books
__ Sex, Drugs and Rock and Roll
__ Biorythms
__ Tea Leaves
__ EST
__ Mantras
__ Jimmy Swaggert
__ Crystals
__ Human Sacrifice
__ Pyramids
__ Wandering around a desert
__ Insurance policies
__ Burning Shrubbery
__ Barney T.B.P.D.
__ Barney Fife
__ Other: _____________________
__ None

7. God employs a limited degree of Divine Intervention to preserve the balanced level of felt presence and blind faith. Which would you prefer (circle one)?
a. More Divine Intervention
b. Less Divine Intervention
c. The current level of Divine Intervention is just right
d. Don’t know…what’s Divine Intervention?

8. God also attempts to maintain a balanced level of disasters and miracles. Please rate on a scale of 1 – 5 his handling of the following (1=unsatisfactory, 5=excellent):
a. Disasters
flood 1 2 3 4 5
famine 1 2 3 4 5
earthquake 1 2 3 4 5
war 1 2 3 4 5
pestilence 1 2 3 4 5
plague 1 2 3 4 5
cable / cell phone providers 1 2 3 4 5
Windows / Apple / Android OS 1 2 3 4 5

b. Miracles
rescues 1 2 3 4 5
spontaneous remissions 1 2 3 4 5
stars hovering over towns 1 2 3 4 5
crying statues 1 2 3 4 5
water changing to wine 1 2 3 4 5
walking on water (except Cuyahoga) 1 2 3 4 5
talking flaming shrubbery 1 2 3 4 5
VCR that set its own clock 1 2 3 4 5
local baseball / football / hockey club winning the Series / Bowl / Cup 1 2 3 4 5

9. Do you have any additional comments or suggestions for improving the quality of God’s services? (Attach an additional sheet if necessary)