United Pentecostal Church International * 8855 Dunn Road, Hazelwood, MO 63042 * 314-837-7300

Missionary Service Evaluation

Please fill out this form following a missionary visit to your church.

Your email address:
Missionary:
Church name:
Pastor's name:
Date of service:	(mm/dd/yy)
Evaluation of DVD/Presentation:	(1=lowest, 10=highest)
Family interaction:	(1=lowest, 10=highest)
Children's behavior:	(1=lowest, 10=highest)
Did they present PIM/Projects:	Yes No
Relay their burden/response:	(1=lowest, 10=highest)
Comments:
*Security code:	type the characters you see in the picture below:

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