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Please fill out this form and return to us by clicking on the submit button. Forms should be completed and sent by the 10th of each month.
~ Thank you ~
 
 
Name:
  
Date:
  
Email:
  
 
1. How can the office of Harvest International be of assistance to you?
 
 
2. How do you rate yourself and your family's development this month?
 
 
(Check one for each item using the following scale)
  
1=Needs attention; 2=Struggling; 3=Satisfactory; 4=Improving; 5=Great
A. Spiritual Development (devotions):
1
2
3
4
5
B. Mental Sharpness:
1
2
3
4
5
   
Relationships with . . .
 
C. Each other:
1
2
3
4
5
D. Missionary co-workers:
1
2
3
4
5
E. National co-workers:
1
2
3
4
5
 
F. Emotional needs met:
Yours:
1
2
3
4
5
Spouse:
1
2
3
4
5
Children:
1
2
3
4
5
 
G. Physical well-being:
Yours:
1
2
3
4
5
Spouse:
1
2
3
4
5
Children:
1
2
3
4
5
 
3. What specific activities have you been involved with this month?
  
(Related to your job description)
 
 
A:
 
B:
 
C:
 
 
4. What are your overall goals for the next two months?
 
For the month of:
 
A:
 
B:
 
For the month of:
 
C:
 
D:
 
 
5. What are the problems, or anticipated ones, about which you would
 
appreciate prayer and/or counsel?
 
Prayer:
 
Counsel:
 
 
6. Information, or materials, needed for the following project:
 
Materials:
A:
F:
B:
G:
C:
H:
D:
I:
E:
J:
 
7. Supplies or personal needs for you and/or your family:
 
A:
F:
B:
G:
C:
H:
D:
I:
E:
J:
 
8. Additional comments:
 
 
 
 
 
 
 
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