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Servant Survey
Grades 3 - 5
Name Grade Age Address
Phone Number Email Address?
School you Attend:
Please rank the following items in the order that you would prefer serving:
(Example: 1 – First choice; 2 – Second Choice; Etc.)
1 2 3 4 5 6 7 8 9 Laser Pointer Assistance (with adult supervision)
1 2 3 4 5 6 7 8 9 Pledge Leader
1 2 3 4 5 6 7 8 9 Lead in prayer during service (Opening; Offering; Etc.)
1 2 3 4 5 6 7 8 9 Assist in leading selected songs
1 2 3 4 5 6 7 8 9 Pass out Servant ID badges
1 2 3 4 5 6 7 8 9 Usher (boys only)
1 2 3 4 5 6 7 8 9 Greeter (helps to pass out information to visitors)
1 2 3 4 5 6 7 8 9 Lighting Control for video projection
1 2 3 4 5 6 7 8 9 Power Point Operator / Laptop (5th graders only)
In your own words, tell me why you should be considered for a “servant” position?
Name of Parent Date
1175 South Main Street, Kernersville, NC 27284