I am employed Full Time

I am employed Part Time

I am primarily a Homemaker

I homeschool my children

My kids go/went to public school

My kids go/went to private or Christian school

I am a homeowner

Other:

2. My age:

3. State of Residency:

4. Number of children:

5. Number of Pets:

6. Ages of children:

7. My occupation:

8. Marital Status:

9. If married, # years:

10. I consider myself:

A seeker/searching for spiritual truth

A believer in Christ/a Christian

Not interested in spiritual matters

Other:

11. Time I spent in church activities growing up:

Less than 2 hours weekly

3-5 hours weekly

More than 6 hours weekly

N/A

Other:

12. On average, the time I now spend in church or church activities for my myself (excluding church employment):

Less than 2 hours weekly

3-5 hours weekly

More than 6 hours weekly

N/A

Other:

13. The time I spend in church or for my children:

Less than 2 hours weekly

3-5 hours weekly

More than 6 hours weekly

N/A

Other:

14. The time I spend on enrichment activities for my children (lessons, sports, music, etc + traveling time):

Less than 2 hours weekly (homework doesn't count)

2-5 hours weekly

6-10 hours weekly

11-15 hours weekly

N/A

Other:

15. The time I spend playing with my children:

Less than 5 minutes daily

5-15 minutes daily

16-30 minutes daily

1-2 hours daily

N/A

Other:

16, The time I spend alone with my husband:

Less than 10 minutes daily (sleeping doesn't count)

10-30 minutes daily

31-60 minutes daily

More than 1 hour daily

N/A

Other:

17. Average time I spend housekeeping:

Less than 30 minutes weekly

30 minutes to 1 hour weekly

1-3 hours weekly

More than 4 hours weekly

N/A

Other:

18. My husband and I go on “dates” together:

Once weekly

2-6 times a year

6-12 times a year

Never

N/A

Other:

19. Average time I spend preparing food:

Less than 1 hour daily

1-3 hours daily

4-6 hours daily

More than 6 hours daily

N/A

Other:

20. What my husband and I usually do during our couple time:

21. The time I spend assisting my kids with homework:

Less than 1 hour daily

1-3 hours daily

3-5 hours daily

N/A

Other:

22.“Me” time (leisure, hobbies, relaxing):

Less than 10 minutes daily

10-30 minutes daily

31-60 minutes daily

N/A

Other:

23. I read my Bible:

Every Day

2-4 times weekly

5-6 times weekly

N/A

Other:

24. I pray:

Every Day

2-4 times weekly

5-6 times weekly

N/A

Other:

25. Time spent in Bible reading:

Less than 5 minutes daily

5-10 minutes daily

11-20 minutes daily

More than 20 minutes daily

N/A

Other:

26. Time spent praying:

Less than 5 minutes daily

5-10 minutes daily

11-20 minutes daily

More than 20 minutes daily

N/A

Other:

27. Time spent in my car:

Less than 30 minutes daily

30-60 minutes daily

1-2 hours daily

3-5 hours daily

More than 5 hours daily

N/A

28. Average hours I sleep each 24-hour day:

2-3 hours

4-5 hours

6-7 hours

8-9 hours

Other:

29. Number of naps I take weekly:

None

1-3

4-6

Every day (lucky goose!)

30. Average length of nap:

Less than 10 minutes

10-29 minutes

30-59 minutes

1-2 hours

31. Time spent food shopping:

Less than 30 minutes weekly

1-3 hours weekly

4-6 hours weekly

Other:

32. Time spent shopping for personal items:

Less than 30 minutes weekly

1-3 hours weekly

4-6 hours weekly

Other:

33. Time spent shopping for family (not for me):

Less than 30 minutes weekly

1-3 hours weekly

4-6 hours weekly

Other:

34. We eat in restaurants or take out:

once weekly

2-3 times weekly

4-5 times weekly

more than 5 times weekly

Other:

35. If I had more time in the day, I’d use it for:

Spiritual Growth

Family Time

Couple Time

"Me" Time

Other:

36. My family eats together:

1 or more meals every day

5-6 meals weekly

3-4 meals weekly

1-2 meals weekly

Other:

37. I am often Too Stressed to Feel Blessed

True

False

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