Date: Date Location: Meeting Location Name of Church Church Name Address: Church Address Diocesan BishopDiocesan Bishop Diocesan Superintendant Superintendant Pastor: Pastor Name Local Superintendant: Local SuperintendantAddress:Superintendant Address Sup. Phone: Superintendent Phone Local Secretary Local Secretary Secr. Phone : Secretary Phone Number of Scholars: No. of Scholars Teachers & Officers: Teachers& Officers Number of Classes: No. of Classes Number of Active Members: Active Members Number of Inactive Members: Inactive Members Average Attendance Last Semi-annual: Avg Last Semi Average Attendance This Semi-annual: Avg This Semi Number of Sunday school Scholars baptized: No. Baptized Number of Sunday school Receiving the Holy Ghost: No. Spirit Filled Amount of Offering Last Semi-annual: Offering Last Semi This Semi-Annual: Offering This Semi Representation Fee ($5.00) Representation Fee Teacher & Officer Representation Teacher & Officer Fee Per Scholar Representation ($.25) Per Scholar Fee Total Paid to National Body (10%) Thru Diocese Total 10% Diocese Total Paid to National Body (10%) Directly Total 10% Direct Diocese Superintendent Love Offering ($15.00) Sup Love Offering Diocese Secretary Love Offering ($5.00) Secretary Offering Scholarship Book Fund Offering Scholarship Offering Director's Love Offering ($10.00) Director Offering Home Mission Offering ($10.00) Home Mission Offering Total Amount Submitted with This Report Total Submitted
If mailing in your payment, make your checks or money orders to VIRGINIA NORTHERN DIOCESE Mail to:P.O. Box 183, Sandston, VA 23150 Attn: VND Finance Committee