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Pre-Survey Form
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* Indicates required question
Church Name
*
Your answer
Church Address
*
Your answer
Church Website
Your answer
Church Phone
Your answer
Church Email
Your answer
CHURCH FACILITATOR
Information for the person in the church that we will primarily communicate with.
Name of the Facilitator
*
Your answer
Facilitator Title or Position
Your answer
Facilitator Cell Phone
Your answer
Facilitator Email
Your answer
CONSULTANT/COACH
Who is your AssessmentCoach/Consultant?
Your answer
Anticipated dates of onsite assessment weekend?
Your answer
CHURCH LEADERSHIP
Names, position/title and email address of all pastoral staff:
Your answer
What do you call your primary leadership group?
Your answer
Terms used for leadership:
Do you have "Elders"?
Do you have "Deacons"?
Do you have "Trustees"?
Other:
MINISTRIES
Ministries: (Please list the ministries of the church that you would like to receive feedback from the congregation about.)
Your answer
Worship Services: (Please list the time of all Worship Services you would want included in the survey )
Your answer
GENERAL INFORMATION
Denominational Affiliation:
Your answer
How old is the church?
Your answer
Average Sunday Worship Attendance:
Your answer
Please briefly describe your community?
Your answer
Is the church currently going through any Pastoral, Staff, or Leadership transitions?
Your answer
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