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Ambassador Church Report

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Your Name*
Your PK ID Number*
Your Email Address*
Church Name*
Denomination*
Church Street Address*
Church City*
Church State*
Church Phone*
Church Website
Church EMail Address
Senior Pastor's Name
Senior Pastor's EMail Address
Men's Ministry Leader Name
Men's Ministry Leader EMail
What is the average attendance of the church?*	1-50 51-100 101-300 301-1000 1001-3000 More than 3000
What percentage of adult men in the men's ministry are married?*	10 % 25 % 50 % or more
On a scale of 1-5, how effective is the men's ministry?*	5 - Very effectuve 4 - Somewhat better than effective 3 - Effective 2 - Somewhat not effective 1 - Very ineffective
What is the size of the men's group?*	0-5 Men 6-20 Men 20-50 Men More than 50 Men
Is there a Men’s Small Group Ministry in the church?*	Yes No
Are there any plans to start a Men’s Small Group Ministry?*	Yes No
Is the church interested in resources for the Men’s Small Group Ministry?*	Yes No
On a scale of 1 – 5, what impact has Promise Keepers had on the church?*	5 - very effective 4 - somewhat better than effective 3 - effective 2 - somewhat not effective 1 - very ineffective
How many men plan to sign up for a conference?*
Do they need more promotional resources?	Posters DVD VHS Flyers
Does this Church support Promise Keepers?*	Yes No
If not, why?	Doctrinal differences Cost Past experience Speakers Music/Worship Who is Promise Keepers?
Does this church want a repeat visit?*	Yes No
Additional Comments
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