CLRMS | FEDCO

1. Code (ID) of Field Agent

2. Name of Field Agent

3. Region of Farmer

4. District & Society

5. District & Society ID

6. Farmer ID

7. Name of Client

8. Number assigned to child

9. Does this interview follow-up on a case of child labor discovered during a farm visit (F5) or during the household interview (F4)?

10. Date of discovery on the farm (F5) or in the household (F4)

11. Age of the Child

12. Child's date of birth

13. Sex of the Child

14.Child ID

15.Does the child have a birth certificate?

16.Can the child read and/or write?

17.If the child is between 5 and 17 years old, does he/she go to school?

18.At what age did the child start school?

19.At what age did the child stop shcool?

20. Why is the child not enrolled in school

21. Has the child ever interrupted his/her schooling? (one year enrolled, and the next not enrolled)

22. Please enter the number of years during which the child was not in school, since the child was 5 years old

23. What is the name of the school?

24. What is the child's current educational level?

25. Is the child ever absent from school?

26. What are the reasons for his/her absence from school

27. Does the child live with both his/her parents?

28. Does the child live with his/her mom?

29. Why does the child live with mom?

30. Does the child live with his/her dad?

31. Why does the child live with dad?

32. Since when does the child live in this household?

33. With whom did you live before you became a part of this household?

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