Fueldisha

Full Name

Age

Address

Contact number

Educational qualifications

Number of members in the family

PAN /Adhar Card Number

Skill Possessed

Is the mentee employed

Yes

No

Is the mentee’s spouse employed

Yes

No

Disguised Employment

Employer details of the mentee

No. of years of employment

Monthly Income

Is the mentee’s family dependent on her income

Yes

No

Partially

Does Mentee owe a Smartphone?

Yes

No

Does it have a data plan?

Yes

No

Who uses the phone?

The Mentee

Her children

Others in the household

Does the mentee watch series /movies on the smart phone?

Yes

No

Has the mentee learnt anything related to her work in the last 2 years?

Yes

No

Can’t say

What has she learnt?

Mentee Registrations