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Business ClinicÂ
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A. General Background Informationn
(Taarifa za Awali kwa ujumla)
Name of participants/ Group
*
Your answer
Sex
*
Male
Female
Group Status
General
Disadvantaged
Clear selection
Date of Birth
MM
/
DD
/
YYYY
Business Registration Status
Registered
Not Registered
Clear selection
Business Registration Date
MM
/
DD
/
YYYY
Business Description
*
Your answer
Level of Capital
1million- 5million
6 million- 20 miliion
21 million - 50 million.
50 million- 100 million
Above 100 million...
Clear selection
Martital Status
Single
Married
Divorced
Widowed
Clear selection
Physical Address
Your answer
Telephone Numbers
Your answer
Email
Your answer
Number of children living with you(including yours)
Your answer
Level of education attained
None
Primary level
Secondary level - form four
Advance Level - form six
University/Collage level
Clear selection
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