M/E International, Inc.

VE Data Template

Cassette Discipleship Program

Fill-in the necessary Information so we can identify who YOU are.
NOTE: all BOXES will take and contain more information than expected.

1. Report Date: YYMMDD example: Nov 1, 2004 would be: 041101

2. VE No.
(Site) CC SC DC OC VEC
( Cntry Code - State - District - Outpost -VE)

3. Start Date YYMMDD
End Date: YYMMDD

4. Country:

5. Name: Last First Middle (of Person)
E-mail

6. State District Key Village

7. Population of: State District

8. Person Data: Age Married?Yes No Children?Yes No

9. Spouse Name: Children - Name(s):

10. Education: Highest Grade:

11. How long have been a VE? Years Months

12. Activities over last 3 mns: Activity Dates: From to

Number of Villagers Reached Number of Villagers came to Christ:

13. What would you like to comment on? Your Testimony Your Vision Website Problem? Villager Testimony

14. Enter your comments in the space provided below:

15. Person Picture (.jpg file)
via Internet - VE, Villagers or Supervisor (one per message)

16. Picture of Area (.jpg file) via Internet

17. Current Report Received from You: Yes No

18. Check which year and quarter with an "X":

Year: 2003 2004 2005
Qtr.

Year: 2006 2007
Qtr.

19. Tell us how to get in touch with you: