Preliminary data for a Consultation
Instructions:  Complete both pages of this form and mail it to:
Carl George
P. O. Box 5407
Diamond Bar, CA 91765  
Or, you may fax it to 909-433-2129. 
For questions, call and leave a voice mail message at 909-396-6843.

Date this information prepared: _______
Prepared by ______________________ Position ______________________
E-mail of preparer _______________________
Phone ____________________  Fax _______________________

1. Senior Pastor's Name ______________________________.
   E-mail ___________________
2. Year of birth _________; Year of coming to this church ___________
3. Family at this time ___________________; Health ________________
4. Where took training for ministry _____________________________
5. Church name _____________________________________________
6. Church street address ______________________________________
7. Church city, state, zip ______________________________________
8. Church main phone number _______________________________
9. Church fax number _______________________ Is FAX available at all hours? ____ Must one call first? ____
10. Church web site URL __________________________________
11. Year church organized __________
12. Denominational affiliation ____________________________________
13. Usual seating capacity of main hall ____________
14. Avg. weekly attendance (adults & children), last full calendar year ______ Average weekly attendance, five years before that _________
15. Income from donations to general budget, past full year: _________
16. Building program or fund drive in process? _______________________
17. Do members consider the church location safe and desirable? ____
18. About how many first time visitors came to your services in the last twelve months? _____ Is this above or below the previous year? ______
19. How many worship services are held each week? _______
20. What worship styles are used? _______________________________
21. Do you have a day school? ____ For what grade levels? _______ How many students? _______
22. Do you have a book store? _________
23. What use do you make of direct mail, radio, television? ____________ ________________________________________________________
24. With what community outreach/service programs is the church involved? _________________________________________________________
25. How do you engage in evangelistic or church planting missions at home or abroad? __________________________________________________ ________________________________________________________
26. Up-to-date organizational charts for paid staff and for volunteer staff and for boards and committees will be needed at some point. For now, send copies of whatever existing charts are available.

• boards and committees,
• the music ministry,
• the youth ministry,
• the children's ministry, and
• leadership training and supervision.)

Why do you want consulting help at this time?

What do you hope to gain from it?