PennDel Ministry Network | Acts 2 Journey

Pastor's Name*

First Last

Pastor's Phone*

Pastor's Email*

Spouse's Name

First Last

Spouse's Phone

Spouse's Email

Church Name*

Church Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Church Phone*

Church Website

Did your church complete the General Council ACMR for the previous year?*

Yes
No

Are you and your church leadership willing to fully commit to the four quarterly retreats?*

Yes
No

What previous avenues have you tried for church revitalization? What were the results?*

What do you and your church hope to gain by participating in the Acts 2 Journey?*

Which location will you attend?*

North-West (Emlenton, PA)
Central (Mechanicsburg, PA)

CURRENT YEAR Vital Statistics

Average Sunday AM Attendance (all ages)*

Salvations/Conversions for Year*

Year Water Baptisms*

Average Sunday AM Children in Attendance (0-12)*

PREVIOUS YEAR Vital Statistics

Average Sunday AM Attendance (all ages)*

Salvations/Conversions for Year*

Year Water Baptisms*

Average Sunday AM Children in Attendance (0-12)*

More Info

Year Church Established*

How long have you been the lead pastor?*

Number of Attendees in Active Ministry*

All Church Attendance Patterns

Current Year*

Current Year - Children (0-18yrs)*

1 Year Ago*

1 Year Ago - Children (0-18yrs)*

2 Years Ago*

2 Years Ago - Children (0-18yrs)*

3 Years Ago*

3 Years Ago - Children (0-18yrs)*

4 Years Ago*

4 Years Ago - Children (0-18yrs)*

In the Past 12 Months

Number of Visitors (visiting “units”/ families)*

Number of Salvations*

Number of Water Baptisms*

Number of Spirit Baptisms*

Payment Options

Payment Type

Credit Card
Check/Cash

Credit Card Payment Options:

Full Payment (Credit Card) - $1,200
Quarterly Payment (Credit Card) - 4 x $300

There are two payment options available: Make a single payment of $1,200 or 4 quarterly payments of $300.

Check/Cash Payment Options:

Full Payment (Check or Cash) - $1,200
Quarterly Payment (Check or Cash) - 4 x $300

There are two payment options available: Make a single payment of $1,200 or 4 quarterly payments of $300. Amount Due today is $0.00. Please submit registration payment to: PennDel Ministry Network 4651 Wesport Dr. Mechanicsburg, PA 17055

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Acts 2 Journey Application