A Church Questionnaire for Supported Missionaries


In an effort to annually assess our missionary workers' needs and activities, Capitol Hill Baptist Church sends the following questionnaire to all of the workers it supports directly or indirectly through the International Missions Board. CHBC's overall evaluation of a missionary is based on lots of other factors, including our personal relationships with the workers. But this form helps inform us about special needs and changes in the workers' activities that we were not already aware of.

In other words, this is not an application which a CHBC church member uses to apply to become a supported worker with CHBC. Rather, it's an annual check-in about the circumstances and needs of workers we already support.

We send it early in the church's annual budget process, and we send it replacing the word "church" with "c" and the word "missions" with "m" for security purposes.

Andy Johnson, CHBC associate pastor



Capitol Hill Baptist Church
525 A Street, NE
Washington, DC  20002

Worker Questionnaire 2008

Note:  Please return an electronic copy of the completed questionnaire by September 01, 20– at the latest. If you need to return a paper copy, please mail it to the address listed above.


Personal Information



Telephone:                               Fax:

E-Mail Address:

Skype Name (if applicable):

Date of Birth:

Spouse/Children's names and birthdays:

Supporting Agency Information

Name, Address and Telephone number of home Church in your country of origin:

Name, Address and Telephone Number of Board or Agency with which you serve:

Appointment date:

Number of years serving in your country?


Relationship with CHBC (attach additional sheets or expand space for responses as needed)

What was your initial connection with CHBC and with whom do you now have contact?

Who is your missions contact person at CHBC? (meaning the person responsible to keep CHBC updated on your life and work)  If you're not sure who that is please tell us that, too.

Are there ways that CHBC members might be genuinely helpful to your work by visiting your country a short-term basis during 2007/08? (We understand that such trips may not be helpful for some workers in some contexts.)

Are there specific ways that you think CHBC could more helpfully partner with your work in 2007 and beyond?

For overseas workers only:  If possible, we would love to have a leader from CHBC visit you in your country of residence during 2007. We would love to have the chance to know your work better, to see how you are doing, and to perhaps impart some encouragement to you.  Is there a particular time during the year that might work best for this?  Is there any reason why this might not be helpful?

Please list items that CHBC might provide that would enhance your work and/or family life.  (Ex: Foodstuffs, educational aids, clothing, business/office supplies, toys, books and magazines, etc.)

Financial Information

What are your current budgeted financial needs?
(Example:  $1500/month)

What percent of your monthly budget needs are pledged?

From where does your giving come?   Please fill in the chart below.




Percentage of Support from…
Number of Entities

Name and contact information for five (5) largest supporters. (optional)
This information will help us in the event you need help in an emergency or we wish to coordinate with others to provide assistance for a special project or special need.





How much financial support do you receive from the congregation of which you are a member? (total dollar amount or percentage of overall support)


Work's Strategic Importance (You may attach separate pages, if necessary)

Give a brief description of your present work: the people who benefit and the challenges you face.

Please give a brief assessment of your work's strategic importance.

Have there been any significant changes in your work in the past year?

How do you envision your work changing over the next year? Five years?

Corresponding with You

When do you plan your next home leave and where will you live during that time?  (Please give name, address and phone number of the best contact for your stateside visit)

What is the best way for CHBC leadership to be in contact with you?
E-mail____         Skype _____        Post _____

What is the most effective method for you to communicate to CHBC your current needs and activities?     E-Mail ____            Skype____           Post _____

(Please advise us if any correspondence is sensitive due to your security concerns.)

Thank you for your time!
Andy Johnson

Andy Johnson serves as a pastor in central Asia.

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