Church Name * Organized Gen. Treas. Acct. No. Mail Location Web Address Email Address Fax Telephone Pastor Start Date Pastor's Name (Spouse) Pastor's Address Pastor's Email Address: Home Phone Cell Phone Review Date New Church-Type Mission Sponsor This Year Yes No 1-Ministry Title Other Than Assoc. Pastor 1-Assoc. Pastor 2-Ministry Title Other Than Assoc. Pastor 2-Assoc. Pastor 3-Ministry Title Other Than Assoc. Pastor 3-Assoc. Pastor 4-Ministry Title Other Than Assoc. Pastor 4-Assoc. Pastor 5-Ministry Title Other Than Assoc. Pastor 5-Assoc. Pastor Music Dir. Vis. Min. Chr. Ed. (Dir. Min.) SS Supt. Childcare/School (Dir./Principal) Children's Min. Dir. NYI Pres. Youth Pastor Adult Min. Dir Prime Time Dir. Single Adult Min. Dir. Men's Min. Dir. Women's Min. Dir. NMI Pres. Work & Witness Coord. CLT Dir. Church Board Sec. Church Treas. 1- Title Additional Ministry Other Ministry 1 2- Title Additional Ministry Additional Ministry2 3- Title Additional Ministry Additional Ministry 3 4-Ministry Title Other Additional Ministry 4