Prison Ministry Church Survey
Please return to ministries@cccsda.org or fax to 559:347-3120
1. Does your church have a Prison Ministry team? Yes No (circle one)
2. Who is your Prison Ministry Leader?
Name:_____________________________________________________________
Cell Phone:_______________________________________________________
E-mail:____________________________________________________________
N/A_______________________________________________________________
Name:__________________________________________________________
Cell Phone:_____________________________________________________
e-mail:_______________________________________________________
4. Please check the Ministries that your church is involved in.
__State Prison Visitation (Name of Prison________________)
__Federal Prison Visitation (Name of Prison_____________)
__Angel Tree-Children’s Program
7.Please supply your contact info:
Name:__________________________________________________________________
Address:________________________________________________________________
Phone:_________________________________________________________________
Email:__________________________________________________________________
2. Who is your Prison Ministry Leader?
Name:_____________________________________________________________
Cell Phone:_______________________________________________________
E-mail:____________________________________________________________
N/A_______________________________________________________________
Name:__________________________________________________________
Cell Phone:_____________________________________________________
e-mail:_______________________________________________________
__State Prison Visitation (Name of Prison________________)
__Federal Prison Visitation (Name of Prison_____________)
__Angel Tree-Children’s Program
7.Please supply your contact info:
Name:__________________________________________________________________
Address:________________________________________________________________
Phone:_________________________________________________________________
Email:__________________________________________________________________