**If you have received good this month, please submit this mandatory report by the 25th of the month.**

This is required to stay in compliance with World Vision and continue to receive goods. 

POD Information

Recipient Information

Please summarize how the product helped further your ministry (how it was used), who it benefited, how often, etc. For example, “our ministry distributed air mattresses to a local homeless ministry for unhoused individuals.” Please feel free to highlight partners and products that really made a difference.

Please share an individual or family’s story on how God used your ministry and the products to meet a need.

Example Story: In October of 2018, Hilltop Elementary hosted a multi-cultural night to celebrate the rich diversity in their community. This diverse community represents over 30 languages and has over 90% of the student body qualifying for free/reduced lunch. Families who attended the event were able to receive new toothbrush sets. These types of community engagement events are a great way for the local schools, churches, and organizations to come together to be in relationship with the community they are serving.

I give my permission to World Vision, Inc. (WV), and all its affiliated organizations (or agents
thereof), to use my name, photograph, video/film footage, voice recording and/or likeness
thereof recorded this day (“materials”) for the purposes of public relations, public awareness or
education, public service and/or fundraising. This includes occasional granting of permission to
outside organizations, for use of the materials in support of WV ministry objectives. I hereby
hold harmless WV, and all its affiliated organizations, from any liability for use of my image or
likeness, both visually and audibly.

I agree that WV has unlimited use of my image or likeness, both visually and audibly for the
purposes described above, without additional remuneration beyond that, if any, which has been
agreed upon this day.

3- MEDIA IMPRESSIONS (If Applicable)
Please share any news or media coverage your ministry received about a product or distribution. Include a hyperlink to any media/news reports if available.

We would love to hear if you had any challenges distributing the product and help walk alongside you.

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