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Golden West Conference

Southern California & Nevada

Contact Information

Golden West Conference
P.O. Box 1209
Upland, CA 91785-1209
(909) 823.2724

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Church Report Form

Golden West Conference of the
International Pentecostal Holiness Church

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For Period Ending:
Date Submitted:
Church Name:
Church Statistics
1. Beginning Church Members:
a. New Members:
b. Members Dropped:
2. Ending Church Members:
3. Average Sunday Morning Worship:
4. Average Systematic Bible Attendance:
5. Systematic Bible Study Enrollment:
6. Church Prospects:
7. Systematic Bible Study Prospects:
8. Average Number of Contacts Monthly:
9. Number of Systematic Bible Study Teachers:
Spiritual Experiences
10. First Time Converts:
11. Re-dedications:
12. Water Baptism:
13. Sanctification:
14. Deliverance:
15. Holy Spirit Baptism:
Financial
1. Beginning Balance of Month:
2. Receipts:
a. Tithe & Offerings:
b. Designated Offerings:
3. Disbursements:
a. Tithe (10% of 2. a.):
b. Conference Support, 3%:
c. Other Expenses:
d. Missions*:
Ending Balance of Month:
Pastor:
Treasurer:

*Please use the Church Financial Disbursements Form with this line item.

Church Financial Disbursement Form

Church Name:
For the Month of:
1. Tithe (10% of Tithes & General Offerings received):
2. Conference Support (3% of Tithes and Offerings received):
3. World Missions:
a. Undesignated Giving:
b. Designated (Missionaries Projects)*:
c. People to People Support:
4. General Evangelism:
5. General Education:
6. Benevolent Institutions:
a. Children's Convalescent Center:
b. Falcon Children's Home:
c. Other:
7. Disbursements on Behalf of Pastoral Staff:
a. Retirement:
b. Brotherhood Fund:
8. Total Payment to Conference:
9. Payment Method:
a. Check Number (If Mailed):
b. Date Check was Mailed:
Pastor:
Treasurer: