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Pastor: Please give this form to the person who oversees your youth ministry. If you don’t currently have a youth ministry, but do have teenagers in your church, please fill out as much of the survey as you can. This should then be sent to the national office of Healthy Ministry Resources, along with your other annual reports.

|CHURCH INFORMATION |

|Church Name       |

|City       |State       |

|Senior Pastor’s Name       |

|Church Website       |Average attendance       |

| |

|YOUTH LEADER INFORMATION |

|Youth leader’s name       |

|Preferred mailing address       |

|City       |State       |Zip       |

|Email       |

|Home phone       |Cell phone       |

|Birthday (m/d/y)       | Fulltime Part-time Volunteer |

|Youth website       |

|The best way to get in touch with me is: |

|Snail mail Email Facebook Cell Office |

|How long have you been involved in leading the youth ministry at your church?       |

|How satisfied have you been with youth ministry over the past year? |

|Very satisfied Mostly satisfied Mostly dissatisfied Very dissatisfied |

|What has been your greatest joy in ministry over the past year? |

|      |

|What has been your greatest frustration in ministry over the past year? |

|      |

|How many adults partner with you in youth ministry on a weekly basis?       |

|Have they received any kind of youth ministry training over the past year? Yes No |

| If so, what kind of training was it?       |

|How many students do you minister to on a weekly basis?       |

|About how many of this number demonstrate the qualities of a student leader?       |

|(Faithfulness, Availability, Teachability, and Responsiveness to God and to church |

|leadership, and show a desire to influence others toward their fullest potential in Christ) |

|Do you meet with this group separately? Yes No |How often? | |

|What would you say is the main reason your ministry to and with teenagers exists? (If you have a written mission/purpose statement, include |

|it here.)       |

|What methods has your church used to help accomplish this purpose over the past year? (check all that apply and check a “letter grade” for |

|its overall effectiveness) |

| Weekly meetings | A B C D F |

|Large group events |A B C D F |

|Small group activities/events |A B C D F |

|Personal appointments with students |A B C D F |

|Other: |A B C D F |

|To the best of your knowledge, how many teenagers made a significant decision for Christ through your youth ministry during the past year? |

|      |

|How did those students come to know Christ? (Write the number next to the appropriate line.) |

|      |Regular youth meeting |      |Special youth event |

|      |Adult non-family member |      |Church service or special event |

|      |Family member |      |Another Christian teenager |

|      |Other:       |

|How many of them are currently active in your youth ministry?       |

|On a scale of 1 to 10 (1= low, 10= high), what is the sense of community and connectedness that you feel your students have with each other?|

|1 2 3 4 5 6 7 8 9 10 |

|How supportive of the youth ministry is the church as a whole? |

|Extremely supportive Very supportive Somewhat supportive |

|Not very supportive Not at all supportive |

|How supportive of the church is the youth ministry? |

|Extremely supportive Very supportive Somewhat supportive |

|Not very supportive Not at all supportive |

| Yes |Were any of your students involved in regular ministry positions in the church as a whole during the past year? (nursery,|

|No |usher, Sunday school teacher/helper, etc)? |

|      |If so, how many? |

| Yes |Have any of your students participated in service |

|No |projects in the church or local community in this past year? |

|      |If so, how many? |

| Yes |Did any of your students participate in local, domestic, or international mission trips during the past year? |

|No | |

| |If so, how many? |      |Local |      |Domestic |      |International |

|With what organizations have your partnered to facilitate your mission experiences? |

|      |

|What are some of your greatest needs in your ministry right now? |

| Mentoring me as a youth leader | More adult volunteers |

| More student leaders | Finances / Budget prep |

| Networking with other churches | Teaching curriculum |

| Mission trip Information | Issues with the senior pastor |

| Training In what areas?       |

| Other:       |

|Which training opportunities, special events, or other opportunities to connect would you most likely take advantage of during the coming |

|year? (Check all that apply) |

|Regional training in the FALL |

|Youth Summit (Daytona Beach, FL, in the SPRING) |

|Week long conferences |

|Internet-based resources |

|Training DVDs |

|Facebook connections |

| interaction |

|Newsletters |

|Email Updates on Regional or Denominational Youth Ministry |

|What else would you like the Youth Lead Team or the national office staff to know? |

|      |

| Check this box if you would like to be contacted by a member of the UB Youth Leadership Team. Please indicate what you would like |

|information on or what you would like to talk about. |

|      |

Thank you for completing this survey. The Youth Lead Team looks forward to reviewing this information and plans to connect with you at some point during the coming months. For more information about denominational Youth Ministry, check out the website at

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