“AN INITIATIVE TO KNOW THEM MORE”

Q.1 NAME - ______________________________

Q.2 AGE - ______________________________

Q.3 TYPE OF DISABILITY - ________________________

Q.4 AGE (when disability stroked) - __________

EDUCATION PROFILE…

Q.5 SCHOOL - ____________________

Q.6 CLASS - ______________________

Q.7 PROBLEMS FACED DURING SCHOOL - __________________

___________________

Q.8 DID TEACHERS AND CLASSMATES SUPPORTED YOU? – YES/NO

Q.9 HAVE YOU NEEDED ANY DEVICE TO OVERCOME DAILY PROBLEMS

DUE TO YOUR DISABILITY? YES/NO

WORKING PROFILE…

Q.10 COMPANY - _____________________

Q.11 POST - ___________________

Q.12 ANY PROBLEMS FACED BY YOU WHEN YOU APPLIED FOR JOB?

YES/NO

Q.13 ARE COLLEGUES SUPPORTIVE – YES/NO

Q.14 HAVE YOU NEEDED ANY DEVICE TO OVERCOME DAILY PROBLEMS

BECAUSE OF YOUR DISABILITY? YES/NO

AS COMPARED TO EARLIER TIMES HAVE YOU FACED ANY POSITIVE CHANGES IN SOCIETY
REGARDING DISABILITY? YES/NO