Church Revitalization Assistance Request Form
Name of Person Submitting
Position in Church
Year Church was Founded
Year Pastor Began
Is the Pastor aware you are submitting this form?
[The TBMB reserves the right to postpone working with the church until first speaking with the Senior Pastor,
unless the position is vacant.]
Number of Baptisms for Each Year:
Current Worship Attendance
Average Worship Attendance 5 Years Ago
Average Worship Attendance 10 Years Ago
Current Sunday School Attendance
Average Sunday School Attendance 5 Years Ago
Average Sunday School Attendance 10 Years Ago
In 25 words or less, what is the most pressing reason for this request?
What outcomes would you like to experience as a church as a result of engaging in our process?
What “official” decisions have been made or discussions have taken place in your church concerning reaching out for assistance from the Tennessee Baptist Mission Board?
In your opinion, what is the general attitude of the members of your church toward seeking assistance in revitalization? Please select one item below that best represents your answer: