| Name and address of your organization: |
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Telephone:
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| E-Mail Address: |
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| Contact Person: |
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| Where is your work located within your country? |
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| What language is spoken? Could English be used in teaching or would
translators be available? |
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| Suggestions for traveling from the US to your country and what are
the traveling conditions within your country? |
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| Describe the medical work being done and the facilities and
opportunity: |
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| What particular teaching needs do you have where MEI can be of help
in sending short-term teachers (formal lectures or
one-on-one)? |
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| What medical or dental specialties are you in particular need
of? |
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| What teaching tools could we use at your
location (PowerPoint, slides, overhead, videos, etc.)? |
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| Would you prefer one person at a time or a team of people and if so,
how many? |
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| When is the best time for us to be there? |
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| Describe the accomodations for visiting personnel: |
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| List costs, if any, for room and board: |
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| Describe travel within the country: |
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| Information about the church or the organization with which you
work, if applicable: |
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| Is there a national or local Christian Medical/Dental organization?
If so, please list contact person, address, etc. |
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| Tell us more about your country or area: |
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| Climate: |
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| People: |
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| Occupations: |
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| Religions: |
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| Political Situation: |
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| Describe anything else which would be helpful in preparing a team
for your project: |
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| Please feel free to expand on any of these questions or add
additional information, which you feel would be important. |
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