Church Information

Name*

First Last

Church Name

Church Phone Number

Church Website

Church Email Address

Providing your email permits SSI to send periodic updates unless you opt to unsubscribe. All personal information is used solely by Student Statesmanship Institute and our partner organizations, and will not be released, rented, sold, or otherwise distributed to anyone at any time for any reason.

How long have you been attending this church?

What programs or what other ways are you actively involved in your church?

Contact Information

Cell Phone

Home Phone

Email

Providing your email permits SSI to send periodic updates unless you opt to unsubscribe. All personal information is used solely by Student Statesmanship Institute and our partner organizations, and will not be released, rented, sold, or otherwise distributed to anyone at any time for any reason.

What are the best ways to reach you? Please list with preferred methods first.

Call cell phone, call home phone, text, email, Facebook, etc.

We currently send out a regular email to our church liaisons to give them information about what’s happening with our programs and how they can help. Is there a better way to send you this information than emailing?

Yes
No

How would you prefer to receive this information?

Would you be interested in a Facebook group to help church liaisons connect with each other?

Yes
No

Church Description

Please describe the church government (elders, deacons, board, etc.).

Name of Head Pastor

Name of Associate Pastor

Name of Youth Pastor

Name of Mission Board Director/Mission Pastor

Please name any other staff with their titles as well as other key leaders in your church with their roles. There may be those who hold a lot of influence in the church but who do not have a title.

Estimate the size of your congregation

What programs and services does your church offer?

Multiple Sunday Morning Services
Sunday Evening Service
Saturday Service
Sunday School
Wednesday Church
Small Groups
AWANA
Prayer Meetings
Other (Please specify below)

Please list any other programs and services your church offers

How many teenagers attend your church?

Does your church currently have summer programming for its youth (camping trips, church camps, mission trips)?

Yes
No

Youth Summer Programing

Please describe the summer youth programs offered at your church

Does the church help with funding?

Yes
No

Are these programs put on by adults within the congregation or outsourced outside of the church?

Yes
No
Some are led by the congregation and some outsourced

Missions

How does your church currently support missions?

Sponsors missionaries
Churchwide mission trips
Supports church plant(s)
Offers support to community
Other

Please describe how your church supports the community

What other ways does your church support missions?

What missions opportunities are the church youth engaged in?

Local mission trips
Out of state mission trips
Out of country mission trips
Other

Please describe any other mission opportunities for the church youth

How active in these mission opportunities are the youth of your church?

Very
Somewhat
Not much
Not at all

Building a relationship with your church

How familiar is your congregation with SSI and/or LEAD?

Almost everyone in the congregation knows about it
Most of the congregation knows about it
Most of the congregation does not know about it
Almost no one in the congregation knows about it

How familiar is your church leadership with SSI and/or LEAD?

Almost all of the key leaders know about it
Most of the key leaders know about it
Most of the key leaders do not know about it
Almost none of the key leaders knows about it

How would you describe the leadership's attitude toward SSI and/or LEAD?

Very enthusiastic
Somewhat enthusiastic
Neutral - Neither enthusiastic nor negative
Negative

Are there any SSI LEAD alumni in the church who might be able to help spread the word or share about the impact of the program?

Yes
No

Of the possible ways your church could partner with us, which do they already do/have already done?

Key leaders met with SSI staff to share the vision of our ministry and programs
Put out brochures and posters
Brought in an SSI staff member to speak to the congregation, small groups, or the youth group
Shared about LEAD on the church’s website or social media, put up a LEAD web banner, and/or put information about LEAD/LEAD brochure in the bulletin
Sent someone from church to observe/help at LEAD
Put together a group from the church to attend LEAD (LEADership Excursion)
Supports SSI as a mission through prayer and/or finances

When considering leaders, families, and anyone else in the church, what would be the best approach for SSI staff to meet people to share the mission of LEAD with your church?

What would be the best next step(s) to develop a partnership with your church?

Thank you for agreeing to be a church liaison!

Contact Information

Church Description

Youth Summer Programing

Missions

Building a relationship with your church