2000 Annual Church Profile Other Church Information

2015 Other Church Information Form (Send or complete this form for your Association – not intended for GBC)

______(Write in your church name) (Association name)

This form is designed to aid you in recording important church information, including significant events and key leaders. This information is for the church’s use. Many associations, however, use this information to compile a list of representatives on the associational executive board. Some associations compile lists of deceased church members for memorial services during annual meetings.

Please fill out the portions of the form that you wish to record, and then return the form to the Association with your other 2015 ACR information. Please use the reverse side or attach additional sheets if you need more space. You may wish to make a copy of the form for your church records.

____Number of Annual Minutes requested for your church ____Amount Enclosed for Annuals ($5.00 per book)

Representatives on Associational Executive Board Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Messengers to Association Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Senior Adult Representative Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Mission(s) Operated by Church Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Change in Pastor If your church had a change in pastor(s) during the year, list the pastor who left and his address. Do not list interim pastors or supply pastors.

Ministers Licensed During the Year Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Ministers Ordained During the Year Name Street, Rt., Box No. City, State, ZIP+4 Telephone No.

Historical Events List historical events of interest that took place this associational yearnew buildings, dedications, new ministries started, etc. Members Deceased During the Year (Indicate Mr., Mrs., Miss, Deacon, Ordained Minister, etc.)