Grant Application/Questionnaire

November 2009 Retreat

Please print legibly

Your Personal Data

Name (First/Last)

Name of Spouse and Children (if applicable)

Home Mailing Address:

Primary Phone Number: (area code) ❑ Mobile ❑ Land

Secondary Phone Number: (area code) ❑ Mobile ❑ Land

Primary e-mail Address:

Your Church Data

Church Name

Senior Minister or Staff Contact Names

Church Mailing Address:

Church Phone Number: (area code) ❑ Mobile ❑ Land

Church e-mail Address:

Church web page:

Denominational Affiliation:

Number of employed ministry/administrative staff:

Which most closely describes your Sunday morning worship service:

❑ Contemporary/Non-Traditional ❑ Charismatic/Enthusiastic
❑ Traditional/Historical ❑ Blended
Your Youth Ministry Position:

❑ Volunteer ❑ Part Time ❑ Full Time ❑ Volunteer

Average hours per week Annual salary paid by church:
Years at present ministry Total years in ministry

Your Youth Ministry Program

Grade range Average weekly attendance

How many adults volunteer regularly for youth programs?
Annual youth budget amount devoted to:
Missions
Fellowship/Recreation
Teaching Materials/Worship Resources
Technology
Continued Education/Professional Conferences/Personal retreats
Other

Using a list or a full description, describe your typical weekly youth meeting:

List influential persons, books, resources, websites, conferences, etc., that have shaped
your current ministry:
Your Educational and Ministerial Experience

What were the two most recent academic institutions you’ve attended:

Institution: Major: Degree:

Institution: Major: Degree:

Are you: ❑ ordained ❑ licensed ❑ lay minister ❑ other

With which church(es)/organization(s) do you hold professional credentials:

What were the two most recent ministerial positions you’ve held (not including present):

Ministry Position: Years There:

Ministry Position: Years There:

Questionnaire

How did you hear about this program? ❑ friend ❑ colleague ❑ web search

❑ institution/other:

Have you ever been on a traditional spiritual retreat before? ❑ Yes ❑ No

If yes, in what practices did you participate:

If selected, would you be willing to read roughly 50 pages/devote five hours to reading
retreat-specific material between now and November? ❑ Yes ❑ No

If selected, will you or your church be able to contribute $90 as your personal
contribution to this grant program ? ❑ Yes ❑ No

Attachments Mail to: Hopwood Christian Church

ATTN: AFR, P.O. Box 149,
Milligan College, TN 37682
 Please attach two (2) letters of recommendation, one (1) from your senior
minister and one (1) from your spiritual director or accountability partner.
Letters should include: (a) your (the applicant’s) name
(b) how long/in what capacity your recommender has
known you and in what capacity
(c) why you should be considered for this program
 Using the back of this application or a separate sheet, write a few sentences about
(1) your current concerns in your spiritual life and ministry; and (2) your
expectations for this retreat program.