Interactive Form:

A visitor to a church website might encounter a submission form like this one where contact information could be collected and feedback and requests submitted.

First
Last
Address
 
City
State
Zip Code
Phone
E-mail
  I am looking for the following: (check all that apply)
  Bible Study Youth Ministry Prayer Choir
  I would characterize my current spiritual state as the following:
  Unsure I've lost my way Just need encouragement
  What prayer concerns, if any, do you have?
 
  Contact me by: Phone E-mail Mail Not at all
 
brother_grady@hotmail.com