I have been in a church position for a few years now. I help set up bi-weekly activities for girls ages 8-11. This week, we are doing a survey on mom and planning a little party for the moms. I made this little survey that I thought others could use for FREE! Then you won't have to make your own. It's not super fancy but it does have some cute font and flowers on the bottom.=) Hope it can help you some.
Here is the link.