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Form 1

1. Name *

First

Last

2. Email *

3. Age *

4. State *

5. District *

6. Block *

7. Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

8. Phone Number *

9. Qualification *

Illiterate
Below 8th
10th
10+2
Graduate
Masters

10. Gender *

Male
Female
Others

11. Are you a Person with Disability (PWD)? *

12. Social Category *

Minority
SC
ST
OBC
General
Others

13. Do you have a center space? *

14. Is your centre space *

Rented
Own

15. How many room/s does your centre have? *

One room
Two rooms
Third Choice
More (please mention)

15.1. More (please mention) *

16. What is your average monthly income? *

17. Prior to becoming a Soochnapreneur, what was your occupation? *

18. Could you please share the changes and improvements you have made in your community/village? (min 100 words) *

19. Please upload a minimum of three photos of your center.

20. Which of the following Model do you want to opt for? *

Model 1 – 5 Desktops/ Laptops and 10 Tablets
Model 2 – 2 Desktops/ Laptops and 5 Tablets
Model 3- 1 Desktops/ Laptops and 2 Tablets
Model 4 – 1 Tablet
Model 5 – 1 Printer
Model 6 - 1 Printer and 1 Laptop/ Desktop

21. Do you have a CSC/ e-Governance ID? * *

22. What type of services you provide/will provide at your centre? *

Schemes Entitlements
Digital Services
Digital Literacy
Banking Correspondence services
Other Services (Please Mention)

22.1. Other Services (Please Mention) *

23. Do you have a Digital Trainer for Digital Literacy in your centre? *

24. Where did you first learn about Soochnapreneur? *

Our Website
Social Media
From Friends and Family
From DEF Staff (please provide Staff Name)

24.1. From DEF Staff (please provide Staff Name) *

25. Are you related to any of the existing DEF’s staff? *

26. Upload Your Photograph *

Form 2

1. Rate your self-efficacy and determination towards a goal *

2. Rate your belief in your capacity to pursue a particular goal *

3. Rate your skills that are required to manage a new venture *

4. Rate yourself on the certainty of you functioning as entrepreneur? *

5. How Resilient are you to Tackle and come out from any Adverse Situation *

6. How creative and Innovative are you to come out with New Ideas *

7. How much do you feel emotionally connected and empathetic towards the needs of community at the margins? *

8. How do you rate your quality to vision, plan & set the goal better? *

9. Do you connect and yourself to the recognizing Issues Related to Social-Political-Economic Injustices with Marginalized Communities *

10. How efficient are you in leading the work through Solution Centric Approach? *

11. How do you place your efforts towards achieving the set targets and commitment assigned? *

Form 3

1. Which of the following languages can you speak, write and read *

English
Hindi
Telugu
Marathi
Odia
Kannada
Bengali
Assamese
Tamil
Malayalam

2. Able to apply simple mathematical operation *

Addition
Subtraction
Multiplication
Division

3. Able to communicate verbally as well as in writing *

4. Willing to travel beyond the four walls of your home *

5. Soft spoken and leadership quality *

6. Social and people friendly *

7. Have basic understanding and knowledge of basic digital device and usage *

8. Willing to have her own small digital business centre and running successfully *

9. Know the basic digital operation *

Form 4

1. Write a brief about your Community

a. Total Population *

b. Number of Panchayat Bhawans *

c. Aanganwadi *

d. Aasha Workers *

e. SHG Groups *

f. Schools

i. Primary (5th) *

ii. Junior High School (8th) *

iii. High School (10th ) *

iv. Senior Secondary (12th ) *

g. No. of ST population *

h. No. of SC Population *

i. No. Of OBCS *

j. No. Of Minority *

k. No. Of PwDs *

l. Male Female Ratio *

m. Literacy rate of your village *

Form 5

1. How do you typically spend your free time? *

Reading books or watching movies
Hanging out with friends or relatives
Engaging in outdoor activities like hiking or camping
Working for the benefit of the community

2. How would you describe your level of influence within your community? *

High: I am a recognized leader or influencer within my community.
Moderate: I have some influence within my community, but not necessarily as a leader.
Low: I have little to no influence within my community.

3. How would you describe your desire to have an impact on your community? *

I actively seek opportunities to make a positive impact in my community.
I am open to making a difference in my community, but I do not actively seek out such opportunities.
I am not particularly interested in having an impact on my community.
Other (please specify).

3.1. Other (please specify).

4. What is your opinion on social media? *

I think it's a great way to stay connected with friends and family
I use it sparingly and try to limit my time on it
I think it's a necessary evil in today's world
I think it's a toxic influence on society and try to avoid it altogether

5. How do you approach decision-making? *

I usually go with my gut instinct
I weigh the pros and cons carefully before making a decision
I seek advice from others before making a decision
I avoid making decisions whenever possible

6. What is your political affiliation? *

Conservative
Liberal
Moderate
I don't have a political affiliation

7. How do you feel about taking risks? *

I'm not a risk-taker and prefer to play it safe
I'm willing to take calculated risks
I enjoy taking risks and seeking out new experiences
I avoid taking risks whenever possible

8. How do you react when faced with conflict? *

I try to avoid conflict whenever possible
I confront the issue head-on and try to find a resolution
I tend to be passive-aggressive and avoid direct confrontation
I let the other person have their way to avoid conflict

9. How do you handle stress? *

I try to stay calm and focus on problem-solving
I tend to get anxious and irritable when stressed
I seek support from friends and family
I avoid stressful situations whenever possible

10. What is your approach to time management? *

I tend to procrastinate and leave things until the last minute
I prioritize my tasks and try to tackle them in a timely manner
I tend to be disorganized and struggle with time management
I let others manage my time for me

11. How do you feel about authority figures? *

I respect authority and tend to follow rules and regulations
I question authority and tend to challenge rules and regulations
I tend to ignore authority and do what I want
I am indifferent to authority and tend to go along with the status quo

12. How do you view yourself in relation to others? *

I tend to be self-centered and focus on my own needs and desires
I strive to be empathetic and considerate of others' feelings
I tend to put others' needs before my own
I struggle to form meaningful connections with others.

13. How do you handle failure? *

I tend to give up easily when faced with failure
I use failure as an opportunity to learn and grow
I tend to blame others or external factors for my failures
I avoid taking risks to minimize the chance of failure

14. What is your communication style? *

I tend to be direct and assertive in my communication
I prefer to communicate indirectly and avoid confrontation
I tend to be diplomatic and find ways to compromise
I struggle to express myself and communicate effectively

15. How do you feel about change? *

I prefer stability and routine and avoid change whenever possible
I'm willing to adapt to change when necessary
I actively seek out new experiences and embrace change
I find change stressful and overwhelming

16. What is your opinion on education? *

I think education is important and necessary for success
I believe that formal education is overrated and not necessary for success
I believe that education should be accessible to everyone regardless of financial status
I believe that education should focus more on practical skills than theoretical knowledge

17. How do you feel about personal responsibility? *

I believe that individuals are solely responsible for their own success or failure
I believe that external factors like luck and circumstances play a significant role in determining success or failure
I believe that society has a responsibility to ensure that everyone has equal opportunities for success
I believe that personal responsibility is overrated, and that success or failure is largely determined by chance.

18. What is your opinion on organized religion? *

I am religious and believe that organized religion is important for spiritual growth and guidance
I am spiritual but not religious and believe that organized religion is unnecessary for spiritual growth
I am not religious and believe that organized religion is outdated and irrelevant
I have mixed feelings about organized religion and its role in society.

19. How do you view conflict resolution? *

I believe that conflict should be resolved through compromise and negotiation
I believe that conflict should be resolved through force or assertiveness
I believe that conflict should be avoided whenever possible
I have mixed feelings about conflict resolution and believe that it depends on the situation.

20. How do you feel about the environment? *

I am very concerned about the environment and believe that individuals have a responsibility to protect it
I am somewhat concerned about the environment but believe that economic growth should take precedence
I am indifferent about the environment and believe that it's not a significant issue
I am actively opposed to environmental protection measures and believe that they are unnecessary and costly.

21. How do you feel about technology? *

I embrace technology and believe that it has improved our lives in many ways
I am cautious about technology and believe that it has both positive and negative impacts
I am skeptical of technology and believe that it is causing more harm than good
I am opposed to technology and believe that it is a threat to our way of life.

22. How do you view your own strengths and weaknesses? *

I am confident in my abilities and tend to focus on my strengths
I am aware of my weaknesses and actively work to improve them
I am overly critical of myself and tend to focus on my weaknesses
I am indifferent about my strengths and weaknesses and don't think about them much.

Entrepreneurship based Survey

1. How comfortable are you with taking risks? *

I avoid taking risks whenever possible
I take calculated risks based on research and analysis
I enjoy taking risks and thrive on uncertainty and unpredictability
I take unnecessary risks without thinking about the potential consequences.

2. What is your approach to problem-solving? *

I tend to follow conventional methods and solutions
I look for creative and innovative solutions to problems
I tend to rely on intuition and gut feeling to solve problems
I tend to avoid problems or delegate them to others

3. How do you handle failure in the context of entrepreneurship? *

I tend to give up easily when faced with failure
I use failure as an opportunity to learn and improve my approach
I tend to blame external factors or other people for my failures
I avoid taking risks to minimize the chance of failure

4. How do you feel about networking and building relationships? *

I am uncomfortable with networking and find it difficult to build relationships
I see networking as a necessary evil and do it only when necessary
I enjoy networking and building relationships and see it as an opportunity to learn and grow
I see networking as a waste of time and prefer to focus on other aspects of entrepreneurship

5. How do you approach competition in the context of entrepreneurship? *

I avoid competition whenever possible and focus on my own strengths
I try to outcompete my rivals by offering better products or services
I collaborate with my competitors to find mutually beneficial solutions
I ignore my competitors and focus on my own goals and objectives

6. As an entrepreneur, how do you handle uncertainty and ambiguity? *

I find uncertainty and ambiguity to be overwhelming and stressful
I use uncertainty and ambiguity as an opportunity to learn and adapt
I enjoy uncertainty and ambiguity and thrive in unpredictable situations
I avoid uncertainty and ambiguity and prefer stability and predictability

6. How do you approach failure? *

I see failure as a setback and tend to give up easily when faced with it
I use failure as an opportunity to learn and improve my approach
I blame external factors or other people for my failures and avoid taking responsibility
I avoid taking risks to minimize the chance of failure

7. How do you approach innovation? *

I prefer to stick to traditional methods and avoid innovation
I am open to innovation but prefer to wait and see how it plays out before adopting it
I actively seek out new and innovative ideas to differentiate myself from competitors
I am overly enthusiastic about innovation and tend to adopt it without considering potential risks and downsides.

8. How do you approach marketing? *

I avoid marketing and rely on word-of-mouth and referrals to build my business
I see marketing as a necessary expense but am not particularly interested in it
I enjoy marketing and see it as an opportunity to connect with customers and build my brand
I am overly focused on marketing and neglect other aspects of my business.

9. How do you handle setbacks and challenges as an entrepreneur? *

I tend to give up easily when faced with setbacks and challenges
I use setbacks and challenges as an opportunity to learn and improve my approach
I blame external factors or other people for setbacks and challenges and avoid taking responsibility
I avoid taking risks to minimize the chance of setbacks and challenges.