HUMANITARIAN DAY INTERNATIONAL (HDI)
Division of ILM Foundation, a 501c 3 USA Nonprofit Organization.
ORPHAN PARENT FORM
The purpose of this form is to allow HDI learn more about the orphan parents and how to be of greater assistance.
Date
-
Month
-
Day
Year
Date Picker Icon
Parents' Full Name
First Name
Last Name
Number
-
Area Code
Phone Number
Email
example@example.com
English Understanding
How do you speak in English?
Average
Below Average
How do you write or type in English?
Average
Below Average
How do you read in English?
Average
Below Average
For WhatsApp do you want text messages and video in English or your local language?
English
My local language
What local language?
Hausa
Twi
Fante
Other
Parent Education Background
Do you have any computer training?
Yes
No
Would you like any computer training?
Yes
No
What mobile applications do you use most ?
What level of Education did you complete?
Primary School
Junior Secondary
Senior Secondary School
Vocational School
College or University
Islamic school
Other
What school subjects did you like?
What school subjects did you not like?
Do you want to complete your education?
Yes
No
If yes, when do you want to start your studies?
How will this help your family?
About Your Work
Do you work?
Yes
No
Do you have your own business?
Yes
No
What type of business?
What type of work?
How do you provide for your family?
Do you have a bank account?
Yes
No
Do you have life plan?
Yes
No
About Your Health
How is your overall health?
Good
Average
Below Average
Do you need help with any health problems?
Yes
No
Are you taking any medications?
Yes
No
Do you need help with any health issue you may have?
Yes
No
What do you do to feel better if you get sick?
How do you stay healthy?
How do you relax and have fun?
If you become very ill, who will take care of you children?
About Your Family
Where is your family from?
How many brothers and Sisters do you have?
Where does most of your family live?
How often do you see your family?
What is the main thing you learned from your family growing up?
What level of education do you want your children to finish?
Primary School
Junior Secondary School
Senior Secondary School
Bachelor Degree College
Masters Degree College
PhD
How often do you visit you child's school?
None
below three times year
above 4 times a year
What does your child want to become in the future?
Do you have a life plan for your child?
ISLAMIC STUDIES
What do you understand about Islalm?
Not much
The basics
Many Subjects
How did you learn Islam?
Do you still study Islam?
Yes
No
What do you do now to study Islam?
Do you want to learn more about Islam?
Yes
No
Do you want your children to learn about Islam?
Yes
No
How are your children learning Islam?
Do you need help to learn more Islam?
Yes
No
THANK YOU!
Submit
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