Under The Son Ministries - Christian Victim Abuse Form

CONFIDENTIAL

If you are living outside of Canada, please contact Trinity Foundation Inc. at www.trinityfi.org

If you have been victimized by a ministry or televangelist in Canada and you would like to share your story with us, you can do so by either completing the form below or calling us by telephone at (306) 682-6166. Once you have submitted the form, a copy will be emailed to you for your records.

All information submitted will be handled with the strictest of confidence.

WE WILL NOT SHARE ANY OF YOUR INFORMATION WITH ANY OUTSIDE ORGANIZATION OR AGENCY WITHOUT YOUR PERSONAL CONSENT.

If you are in urgent need of assistance, please let us know and someone will contact you.

Preliminary Questionnaire

November 20, 2008, 1:23 am

Ministry Being Reported:

Where is the ministry located? Please be as specific as possible.

Complainant

Name:
Address1:
Address2:
City:
Province / State:
Country:
Postal / Zip:
Phone:	( ) example: (306) 555-1212
Email:

Victim Information

Name of victim if different from complainant:

Relationship of the victim to you:

Address1:
Address2:
City:
Province / State:
Country:
Postal / Zip:
Phone:	( ) example: (306) 555-1212
Email:

Age of Victim:

Sex of Victim: Male Female

Convenient Time to Call:

Please summarize your story:

1.	When did you first have contact with the ministry? Date?

2.	What attracted you?

3.	What was your need or emotional condition at the time?

4.	Is this ministry presently on the air? Yes No

5.	When and where did you last see the program?

6.	a) When did you last contact this ministry?
	b) When did they last contact you?
	c) Have you kept your letters, requests, or written answers to your prayers or any records of correspondence to you from the ministry? Yes No
	d) If yes, would you keep the originals and allow us to copy the same? Yes No

7.	Did they make a specific promise that they did not fulfill? Yes No
	b) If yes, what promise did they make?
	c) If Yes, was this promise made to you in a broadcast, in printed material or in person?
	d) If by broadcast, on what program did they make this promise? If possible, include the date, time and channel it was aired on.
	e) If by printed material, do you still have a copy of it? Yes No
	f) If by broadcast, do you have a recording of it? Yes No

8.	a) How much money did you donate to this ministry?
	b) Can you verify and have you kept records of this? Yes No
	c) If necessary, would you furnish us copies of your cancelled checks or money order receipts that you donated to this ministry? Yes No

9.	a) Did you make this donation upon reliance of their specific promise? Yes No
	b) Did they tell you that you had to make this donation in order for them to fulfill their promise to you? Yes No
	c) Did you believe that you had to make the donation in order for them to fulfill their promise to you? Yes No
	d) Were you told or made to feel that if you Did Not donate, you would fall out of God's favor? Yes No

10.	a) Would you release to us your annual income? Yes No
	b) What was your annual income at the time this happened?
	c) What is your most recent annual income?

11.	a) Have you ever received any type of welfare? Yes No
	b) If so, what type?
	c) For how long?
	d) How much?

12.	How has this experience affected your faith?

13.	a) Do you think that these ministries are doing some good? Yes No
	b) In what way or ways?

14.	Would you support more public accountability of ministries like this? Yes No

15.	Would you be willing to join a civil suit against this organization in which you might or might Not receive compensation for the alleged damage that was done to you? Yes No

16.	If Yes, do you understand that by joining such a suit you will probably be asked to testify in open court or by deposition and that your name could be in the paper or on the news? Yes No

17.	Are you financially capable of paying the court costs should you file a civil suit to recover your alleged damages provided the costs are minimal and do Not exceed $500.00? Yes No

18.	From time to time we are contacted by members of the media looking for names of people who are victims. Do we have your permission to give them your name? Yes No

19.	a) Do you know of anyone else that has been injured that might want to talk to us? Yes No
	b) If so would you furnish them a copy of our phone number? Yes No
	c) May we contact them? Yes No
	d) If yes, please provide their contact information.
	e) If yes, when are the best times to contact them?
	f) If yes, will you be making them aware that we may be calling them? Yes No
	g) If we do contact them, may we use your name as a referral? Yes No

20.	Would you be willing to write a letter to the legal authorities about your experience with or concerns about these ministries? Yes No

21.	a) Have you ever been employed by the ministry being reported? Yes No
	b) What was your title?
	c) What was your job?
	d) Who was your immediate supervisor?
	e) At which location?
	f) What was your salary?
	g) What time period did you work for this ministry? From to

22.	Why did you leave?

23.	Any other remarks?
"I have reviewed my answers and comments above and state that they are true to the best of my knowledge and remembrance. I also understand that my information will be kept with the strictest of confidence and will not be released without my consent." Yes No