INFORMATION:

Name: Date:

Email: Phone:

Leader: M. Ulrich M. Patz R. Johnson N. Green E. Ortiz G. Dumaine J. Dressel S. Adams A. Wilkinson S. Maynard J. Scales

THIS PAST WEEK:

I have spent part of every day spending quality time with God:
(Number of days) 1 2 3 4 5 6 7

I have been reading/studying the following scripture in the Bible this week:

My time alone with God was effective and enjoyable: (1=No 10=Yes) 1 2 3 4 5 6 7 8 9 10

I have had a day of rest this week: Yes / No

I have prayed every day for people on my VIP card: (Number of days) 1 2 3 4 5 6 7

I have invested in the life of someone from my VIP list this week:
Yes / No

I have shared the message of Jesus with someone this week:
Yes / No

THIS MONTH: (1=No 10=Yes)

I have had to fight against ungodly thoughts: 1 2 3 4 5 6 7 8 9 10
unbelief, bitterness, anger, lust, pride, jealousy, greed, materialism, racism

I have given appropriate time to my family: 1 2 3 4 5 6 7 8 9 10

I have honored God with my eating and exercise: 1 2 3 4 5 6 7 8 9 10

I feel like I am growing in love for God and people: 1 2 3 4 5 6 7 8 9 10

I have tithed this month: Yes / No

I have compromised my moral integrity: Yes / No
viewing sexually explicit materials, gossiping, greediness

I have attended and been punctual for my meetings/services/ministry this month: Yes / No

I need to talk to someone about something I have done that could jeopardize
my reputation or the reputation of our church: Yes / No

I am being faithful in my ministry role: 1 2 3 4 5 6 7 8 9 10

I have done something for/with the poor this month: Yes / No

I would like to talk to you personally about prayer requests, my ministry role, or personal accountability: Yes / No