FACSAFOUNDATION.ORG SHATTERING THE SILENCE TOUR DOCUMENTARY PROJECT Volume 2 January 2015 | Page 83

9) What is your partner’s religion?
──────Baptist

──────Jewish

──────Pentecostal

──────Hindu

──────Muslim

──────Catholic

──────Presbyterian

──────Mormon (LDS)

──────Episcopalian

──────Assembly of God

────── Catholic

──────Atheist

──────Methodist

──────Agnostic

──────Church of Christ

──────None

──────Buddhist

──────Other (please specify)

10) Length of relationship you and your partner are in now, in months? ──────

11) My partner and I share financial responsibility. Circle One
Strongly

Agree

Disagree Strongly

Agree

Disagree

12) I am a survivor of sexual assault.
Strongly
Agree

Doesn’t

Agree

Apply

Circle One

Disagree Strongly
Disagree

Doesn’t
Apply