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Church Name

Denomination

Church Address

Address

City

State

Zip Code

Country

Church Email

Church Website (if any)

Lead Pastor’s Name

Lead Pastor’s Phone Number

Is your email thesame as church email?

Yes

No

Lead Pastor’s Email Address

Does the church has media team coordinator?

Yes

No

Media Team Coordinator’s Name

Coordinator’s Phone Number

Coordinator’s Email Address

First Trainee's Name

Role in Church For First Trainee

First Trainee Email

First Trainee Phone Number

Do you want to add another trainee?

Yes

No

Second Trainee's Name

Role in Church(for the second trainee)

Second Trainne Email

Second Trainee Phone Number

Does your church media team have access to laptops with minimum specs (16GB RAM, 2.5GHz processor)?

Yes

No

Is your team committed to attending all training sessions over the 2-year period?

Yes

No

What are your church’s current media challenges?

What do you hope to achieve through this training?