Church Name

Church Address

City State ZIP

Church Phone

Church E-mail

Average Sunday School attendance of your church: 0-149 150-349 350-549 550-1,000 1,001-1,500 1,501-1,999 2,000-2,500 2,501+

Check all of the following programs your church provides for children:
Sunday School   Discipleship Training   TeamKid
Graded Children's Choirs  Royal Ambassadors  Girls in Action
MissionKids  Awana         Other:

Date MissionKids was started: 1995 1996 1997 1998  

Number of children enrolled:

Number of leaders:

How is MissionKids used in your church?  Not used in church.

If you use MissionKids in a setting other than a church, please list:

How did you hear about MissionKids?
Brochure    Direct mail    Article in state paper
LifeWay Christian Stores/Baptist Book Stores
North American Mission Board catalog
Southern Baptist Convention
Glorieta or Ridgecrest Conference Center
State leader training
Associational leader training
Other:

Did you find the leader book easy to use?
Yes   No   If no, why?

Were the children's activities fun and appealing?
Yes   No   If no, why?

Do you plan to use MissionKids next year?
Yes   No   If no, why?

What suggestions do you have for improving MissionKids?

Name of person requesting registration:

Address where certificate and other information should be sent (if different from church address):

Phone number where questions should be directed (if different from church):

Email address where questions should be directed (if different from church):