Church Data Form

Thank you in advance for filling out this form!! We appreciate you.

The information below is needed before we can run your reports or schedule your interpretation. Incomplete information will prevent us from providing church leadership with accurate reports to help guide decision making.

Feel free to gather the information first using this Church Data Form and then submit the information below.

Church Name *

City *

State *

Your Name *

First

Last

Contact Email *

1. What would you estimate has been the population trend during the past 3 years within one mile of your church? *

2. What would you estimate has been the trend in income level during the past 3 years within one mile of your church? *

3. Please enter the numerical size of your church based on the most recent time to count membership. If you do not have a category for church membership, please provide the number of persons you consider to be actively involved and committed to your church's ministry. *

4. Please enter the numerical size of your church 1 year earlier (using the same criteria above). *

5. Please enter the numerical size of your church 2 years earlier (using the same criteria in Q3). *

6. Please enter the numerical size of your church 3 years earlier (using the same criteria in Q3). *

7. Please enter the number of new members received by your church in the past 12 months. If you do not have a membership category, leave blank.

8. Please enter the number of new members received by your church 1 year earlier. If you do not have a membership category please leave blank.

9. Please enter the number of new members received by your church 2 years earlier. If you do not have a membership category, leave blank.

10. Please enter the number of new members received by your church 3 years earlier. If you do not have a membership category, leave blank.

11. Please enter the number of your average weekly worship attendance over the past twelve months (include online worship attendance). *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

12. Please enter the number of your average weekly worship attendance 1 year earlier (include online worship attendance). *

13. Please enter the number of your average weekly worship attendance 2 years earlier (include online worship attendance). *

14. Please enter the number of your average weekly worship attendance 3 years earlier (include online worship attendance). *

15. Church Assessment Roll - How many people did your church invite to take the survey? *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

16. How many different households were represented by the persons on the Church Assessment Roll? For example, partners who live together would be 2 people on the Church Assessment Roll but count as only 1 household. This number helps us calculate part of your report. *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

17. How many different households contributed financially to the church in the most recent year (those for whom you have a record of their contribution)? *

18. Please enter the dollar amount of your total receipts in the last 12 months. Please INCLUDE income for capital campaigns, debt-reduction campaigns, and special mission offerings. Please DO NOT INCLUDE income from endowments, income from facility rentals, preschool tuition, etc. *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

19. Please enter the dollar amount of your total receipts 1 year earlier (same exclusions apply). *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

20. Please enter the dollar amount of your total receipts 2 years earlier (same exclusions apply). *

To ensure accuracy, please provide an estimated number. Please note that 0 is not a valid entry for this field.

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