Section I: Personal Characteristics:

Gender
Male Female

Age
Under 14 14-17 18-22 23-28 29-34 35-39 40-44 45-49 50-60 Over 60

Marital Status
Single, never been married Engaged Married Living with someone Separated or Divorced Widowed

If married, or have been married, how many children are currently living in your household?
None One Two Three Four or more

Formal Education Completed
Junior High School High School Technical School Some college College Post-graduate Study None

If you are currently in school, at what level are you?
Junior High School High School College Master's Program Doctoral Program Post-Doctoral Program

What is your occupation?
Student Business owner Sales/Marketing Trade/Labor Management Technical Administrative Medical Homemaker/Full-time parent Education Professional Engineering Retired Not employed Other     Please state other:

What is your annual household income (U.S. Dollars)?
Under $20,000 $20,000 - $29,999 $30,000 - $39,999 $40,000 - $49,999 $50,000 - $59,999 $60,000 - $74,999 $75,000 - $100,000 Over $100,000

How long has it been since you and/or your family migrated from Lebanon/the Middle East?
0-5 years 6-15 years 16-25 years More than 25 years

Section II: Geography and Demographics

Country of Residence
Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d'Ivoire Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador England Equatorial Guinea Eritrea Espana Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (South) Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Ireland Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa (Independent) San Marino Sao Tome and Principe Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka St. Helena St. Pierre and Miquelon Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay USA Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wales Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe

How would you describe the size of the city in which you live?
Small Medium Large

Please indicate your ethnic origin.
Middle Eastern Lebanese Syrian Jordanian Chaldean Assyrian Iraqi Saudi Kuwaiti Egyptian Turkish Greek Palestinian African Caucasian Asian (including Oriental, Filipino and Pacific Islander) African American Hispanic Native American Other     Please state other:

How many languages do you speak?
One Two Three Four or more

Please specify the languages you speak and the corresponding level of fluency. Check one or more
English   Please select Fluent Non-Fluent
Arabic Please select Fluent Non-Fluent
French Please select Fluent Non-Fluent
Spanish Please select Fluent Non-Fluent
Portugese Please select Fluent Non-Fluent
Armenian Please select Fluent Non-Fluent
German Please select Fluent Non-Fluent

Which of the following best characterize your main hobbies and interests ?
Reading/Writing Sports Travel Music Movies/TV Art Dance Yoga/Meditation Crafts Cooking Internet News, politics & world events Video games Nightlife (bars/pubs/clubs/fine dining) Philosophy/Spirituality Computers/Electronics Shopping Social cause/activism Finance Home improvement Astrology Other     If other, please specify:

Section III: Culture

When you think of Lebanon what images do you see?
The Cedar The Flag Family members The Mountains or the sea The Food A village Other man made vessels Other geographic locations Social life The climate Tourism

How important is your heritage to you?
Not very important, Interesting but does not immediately effect my life, Pretty important

If you are not originally from Lebanon have you ever been there?
Yes No

When is the last time you visited Lebanon?
Within the last year Within the last two years Three years ago More than three years ago

If you answered no, will you ever go?
Yes No

Section IV The Internet, You and Your commitment to Your Heritage

Do you own a computer?
Yes No

Do you have access to the Internet?
Yes No

How many hours per day do spend "surfing" the Internet for pleasure?
0-2 2-3 3-4 5 or more

For what purpose do you generally use the Internet?
Work School Research Entertainment

Do you frequently visit web sites about Lebanon or Lebanese culture and people?
Yes No

Have you ever engaged in an on-line discussion forum concerning Lebanon or Lebanese culture and people?
Yes No

Have you ever attended a national or international convention related to your culture, nationality or religion?
Yes No

Have you built any relationships via the Internet with other Lebanese, not immediately within your local vicinity?
Yes No

What is the content you generally seek from Lebanese web sites?
Cultural information News updates Political activism Religious sites

Are certain symbols an indicator that the site you are on is Lebanese, i.e. pictures, maps?
Yes No

Do the symbols encourage you to stay on the site?
Yes No

What is the most common symbol you see/or look for?
The Cedar The flag A map outline of the country A religious symbol Pictures of popular Lebanese figures

What is the most common language you find on these sites?
Arabic French English Spanish Portuguese Other     If other, please specify:

Where are the majority of sites you visit about Lebanon/Lebanese located geographically if you are aware?
Lebanon Australia S. America C. America U.S. Canada Europe Other     If other, please specify:

What is the average amount of time you spend on content based (not shopping related) web site?
0-3 mins. 3-5 mins. 5-7 mins 8 mins. Or more

What is the average amount of time you spend on a Lebanese website?
0-3 mins. 3-5 mins. 5-7 mins 8 mins. Or more

Do you mainly keep in contact with your Lebanese friends and family through:
Hand written letters Telephone E-mail On-line chats Personal visits

Section V: You and the Church

Do you share the same religious affiliation as your parents?
Yes No Not Sure

Have you always adhered to this religious identity or did you convert to it?
Yes, I have always adhered to this religious identity No, I have recently converted to this religious identity

What motivated you to adopt this religious identity/set of beliefs?
My culture Research A school course Friends My spouse or significant other A positive or negative experience My family…I was raised this way Not sure Other motivation     If other, please specify:

Have you researched other religions?
Yes No

How much do you know about your faith?
Nothing at all A little Quite a bit

Which of the following best describes your religious affiliation?
Christian Muslim Buddhist Jewish Other     If other, please specify:

If Christian, what denomination/Church do you belong to?
Maronite Roman Catholic Melkite Eastern Catholic Eastern Orthodox Coptic Baptist Methodist Presbyterian Mormon Lutheran Anglican Episcopalian None No Answer Other     If other, please specify:

Are you or your parents a member of a parish?
Yes No

How often do you attend Church?
Regularly Occasionally Rarely Never No Answer

Why do you attend Church? (Select all that apply)
To participate in Mass and worship God To fulfill my spiritual obligation Because of habit and duty Because of fear and guilt To socialize with family and friends To network and establish business connections To participate in Church-sponsored activities To find a spouse All of the above Not Sure Other reason     If other, please specify:

If you do not attend Church regularly or at all, please state why (Please select all that apply)
I am very busy Church is too far I have other activities and obligations to fulfill on Sundays I am too tired on the weekends Church is no longer relevant to modern life There are too many hypocrites who attend Church Mass is too long Organized religion places too many rules and restrictions Religion is personal…I prefer to express my faith privately I can pray better at home I do not obtain spiritual fulfillment from Church I dislike the preacher(s) Bad experience with the religion/minister I do not believe in organized religion I do not have time to dedicate to going to church It is unimportant to me Not sure Other reason     If other, please specify:

What role does the Church play in your life?
The Church guides my daily life and acts as my moral compass The Church, to a limited extent, has an impact on my daily life The Church does not have an impact on my daily life The Church has a negative impact on my life

Please rank the following categories by the order with which you identify yourself (i.e. 1 being the category with which you most identify and 4 being the one with which you least identify
1 Most 2 3 4 Least Religion
1 Most 2 3 4 Least Nationality/Ethnicity
1 Most 2 3 4 Least Profession
1 Most 2 3 4 Least Political Affiliation
1 Most 2 3 4 Least Social Affiliation

To what extent do you view religion as part of your identity?
My religion is an important part of my identity My religion is somewhat of an important element of my identity My religion is not an important part of my identity

In your opinion, how significant is religion to our modern society?
It is very beneficial to society It is somewhat beneficial to society It is very detrimental to society It is somewhat detrimental to society It has no impact on society

What role does religion play in political and social change?
Religious beliefs and affiliations influence world politics Religious beliefs and affiliations do NOT play a role in world politics Not sure

Should the Church play a role in influencing social and political change?
Yes, the Church has an obligation to influence social/political change No, the Church should confine itself to spiritual matters only The Church should only be involved when it comes to responding to gross injustices Not sure

Should the Church play an active role in promoting the values of democracy?
Yes No Not sure

Should the Church play an active role in denouncing human rights violations?
Yes No Not sure

Has the leadership of the Church been effective in inspiring change through pastoral letters, statements, etc…?
Very much so Somewhat Not at all

Does the Church encourage you to be an active participant in your community?
Definitely Somewhat Not at all Not sure

Are you involved in church activities?
Youth Club Bible Study Parish Council Event planning and execution (Putting on events and Hafli's) Scouting Retreats Taking care of the church or its property Taking care of the Altar Men's Society Women's society Religious instruction (1st Communion, etc.) Visit the Sick Program Church Committees (Outreach…)

What programs would interest you that are not provided by the Church today?

Would you be willing to work on issues affecting our church or parish?
Yes No

Please specify Issues Above

Section VI. Reclaiming your Lebanese Heritage

Has your birth, marriage, or the birth of your children been registered in Lebanon?
Yes (please click here to send an email request) No

Would you like information or assistance in registering in Lebanon?
Yes No

Would you like to register as a resource in our Professional Registry?
Yes (please click here to send an email request) No

Section VII. Optional Information

Name:
Address:
Address:
City/Locality:
State/Region:
Postal Code:
eMail Address:
Phone Number:
Fax Number: