Belinda's E Learning Module

1

Take Photo* This field is required.

2

Rules and Regulations

Make sure that you write your name and contact details correctly.
The given time for this quiz is 10 minutes. After that, the form will be closed for you.
Attendees who do not submit their answers in time will receive 0.
You can only submit your answers once. If you wish to pause the quiz, please use the Save and Continue Later button.
Each question has its own grading points. After you submit your answers, we will evaluate your answers and let you know your grades later.
If you have any technical problems during the quiz, please take a screenshot or screen recording and send it to us.

3

Attendee Name

Type your Full Name

4

Email Address

5

1. Is the participant able to communicate effectively ? (5 points)* This field is required.

Yes

No

6

2. Does the participant have any visual impairment ? (5 points)* This field is required.

Yes

No

7

3. Does the participant have a gross/fine motor skills deficit ? (5 points)* This field is required.

Yes

No

8

Participant's hobbies and likesSelect multiple answers for this question

Gardening

Volunteering

Driving

Shopping

9

Final Calculation