1.1 Date of interview

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Day Month Year

1.2 Name

1.3 Code

H

1.4 Email

1.5 Phone number

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1.6 Age

| || | years

1.7 Marital status

Married = 1 Single = 2 Divorced = 3 Widow = 4 Separated = 5 Concubine = 6

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1.8 Father’s region of origin

Adamawa = 01 North West = 07

Center = 02 West = 08

East = 03 South = 09

Far North = 04 South West = 10

Littoral = 5 Expatriate = 11

North = 06

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1.9 Mother’s region of origin

Adamawa = 01 North West = 07

Center = 02 West = 08

East = 03 South = 09

Far Nord = 04 South West = 10

Littoral = 05 Expatriate = 11

North = 06

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1.10 Profession/occupation

None = 1 civil servant = 2 Private sector = 3 Student = 4 Retired = 5

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1.11 School Level

None = 1 Primary = 2 Secondary = 3 University = 4

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