For local self-governance Avinab Kumar

1. Questionnaire for Awareness Assessment of GP Residents
Village Name: Srirampur Gram panchayat: Akbarnagar Block: Sultanganj
District: Bhagalpur State: Bihar
A. Schemes of Central Government operated in the GP:
B.
C. General Information – Respondent
1. Name: …………………………………………………
2. Age (in years): ………………………………………...
3. Sex: ……………………………………………………
4. Denomination/Religion: ……………………………….
5. Educational qualification: ……………………………..
D. Socio-Economic Background:
1. Type of family:
1. Nuclear ( )
2. Joint ( )
3. Extended ( )
4. Divorced family ( )
S. No Name of Schemes Estimated Fund (in Rs.)
1
2
3
4
5
6

2. 2. Total family size including yourself (in number): .........................................
3. Father's occupation: .....................................................
4. Mother's occupation: ..................................................
5. Father's income (per month): .....................................................
6. What is/are the main sources of income of your (parental) family…………………...
………………………………………………………………………………………...
7. Total family income from all sources (per month): ..................................
8. Are any of your family members employed? Yes ( ) & No ( )
9. If yes, how many of them are permanently employed? ............................
10. Nature of their employment and Monthly Income
i. Government: ……………………………………
ii. Private sector: …………………………………….
iii. Self-employed: ..…………………………………
iv. If any (please specify): …………………………………..
11. How long is it since your family had been residing in village? ……………………….
D. Skill and Training:
1. What type of skill you have? …………………………….....................
2. Are you doing any training? ………………………………………….
E. Employment Status:
1. Are you employed? (Yes / No)
2. What you do? ……………………………………………………….
3. Place of work ………………………………………………………
F. Awareness about Standing Committee and 3Fs:
1. Are you aware about standing committee in your village? Yes…….… No…………..
If yes,

3. a. Are you a member of any standing committee? Yes…………No……...…..
b. What functions are performed by committee?...............................................
c. Are there any funds available for standing committee? Yes……… No……
d. Which scheme are running under the standing committee in this village?
………………………………………………………………………………
………………………………………………………………………………
e. Is there any fund in sanding committee which is given by Mukhiya?
Yes………….. No………………
2. Details about Functionaries:
S. No Designation Name Contact No.
1. Gram Sachiv
2. Kishan Salahkar
3. A.N.M/ Asha
4. Anganwadi Sevika
5. Rojgar Sevak
6. Indira Aawas
Sahayak
G. Opinions on Governmental Measures, Policies:
1. Have you ever tried for any government schemes? Yes ( ) No ( ).
2. If yes, which one and which year?
i. Departmental Schemes ( ), Year...................
ii. Jawahar Rozgar Yojna (JRY) ( ), Year....................
iii. Self-Employment for Educated Unemployed Youth (SEEUY) ( ),
Year.................
iv. Any Other ( ), Year...................
3. According to you, are the self-employment schemes sufficient for educated
Unemployed youth?

4. i) Fully sufficient ( ) ii) just sufficient ( )
iii) Not sufficient ( ) iv) not at all sufficient ( )
4. According to you, are the funds (money) enough /sufficient for the projects?
i) Yes ( ) ii) No ( ).
5. According to you is the right persons/right educated unemployed youth benefited
from the various self-help schemes/projects?
i) Yes ( ) ii) No ( ).
6. According to you, are the various schemes/loans of self-employment projects properly
utilized or not?
i) Yes ( ) ii) Not Sure ( ) iii) No ( ).
7. According to you, are the educated unemployed beneficiaries really taking up the
projects?
i)Yes ( ) ii)No ( ).
8. According to you, is the government serious in solving educated unemployment
problem?
i) Yes ( ) ii) partially trying to solve ( ) iii) No ( ).