Iranian Revolution and Sacred

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Interviewer Name:
Supervisor Name:
Sample No:
Date Completed:
Rural_____________ Urban____________
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City_____________, District _______________Province______________ -------------------------------------------------

1. General Information

Name ________________________________________________________ ____Age _____________

* About Neighborhood
[ ] I live in shanty houses/slum
[ ] I live in interior city
[ ] I live in housing society
[ ] Other ____________________

* What language do you speak at home?
[ ] Urdu [ ] English [ ] Shina [ ] Balti
[ ] brushiski [ ] Other _______________________________________

* Are you married?
[ ] No[ ] Yes
[ ] if yes, age at the time of Marriage ______ years

* Is your marriage:
[ ] Arranged[ ] Your choice

2. Education Related Information

* Education
* Never went to school/illiterate[ ] parents could not afford[ ] parents didn’t want * primary up to middle[ ] continuing[ ] dropped out * Matric[ ] continuing[ ] dropped out

* Inter[ ] continuing[ ] dropped out
* Bachelors[ ] continuing[ ] dropped out
* Masters[ ] continuing[ ] dropped out

* Father’s EducationMother’s Education
[ ] Never went to school/illiterate[ ] Never went to school/illiterate [ ] Primary up to Middle[ ] Primary up to Middle [ ] Matric [ ] Matric

[ ] Intermediate[ ] Intermediate
[ ] Degree[ ] Degree
[ ] Masters[ ] Masters
[ ] Post doc[ ] Post doc
[ ] Professional Degree Doctor/Eng[ ] Professional Degree Doctor/Eng

* How did you do / are doing at school?
[ ] I am (did) not doing well
[ ] I am (was) an average student
[ ] I am (did) very well in school (among top ten)
[ ] I am (was) the top most students in my class

* How strongly you agree or disagree with the following statements *

| Fully Agree| Somewhat Agree| Somewhat Disagree| Fully Disagree| School teaches life skill necessary to survive | * | * | * | * | School teaches skill necessary to get a job| * | * | * | * | School provides career counseling| * | * | * | * | School has built confidence | * | * | * | * | School has inculcated a desire to learn more| * | * | * | * | School has taught entrepreneurship skills| * | * | * | * |

* Problems Faced in Schooling/Education
[ ] can’t afford
[ ] school is far away
[ ] syllabus in not relevant to market demand
[ ] it is better to start business or do some other activity as employment is difficult to get [ ] other______________________________

3. Job Related Information

* If Job / work / Self Employment
[ ] daily wager
[ ] private sector
[ ] public sector
[ ] owns a business [ ] Small [ ] Large
[ ] professional (advocate/lawyer/consultant/doctor, etc) [ ] not working due to long-term illness/ disability [ ] would like to work but cannot find job
[ ] do not want to work / lack of motivation/enough resources

* Monthly Income Ranges Between
[ ] Below 5000
[ ] 5000 to below 10,000
[ ] 10,000 to below 15,000
[ ] 15,000 to below 20,000
[ ] More than 20000
[ ] Other _________________

* Job Preferences
[ ] self-employed/business
[ ] Government job
[ ] corporate/private job
[ ] teaching
[ ] other

* Problems at Work Place...
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