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QUESTIONS

CODE

01

Name of establishment…………………………

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02

Type of establishment: 1. General public; 2. Technical public; 3. Private secular; 4. Denominational private (precise catholic |__|; presbyterian |__|; islamic |__|)

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03

Age …………

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04

Religion: 1. catholic; 2. Presbyterian; 3. Muslim; 4. Animist;

Other (precise) …………………………………

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05

Marital status: 1. Married; 2. Single; 3. Divorced; 4. Widow;

5. Free union

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05a

If married , regime: 1. Monogamy; 2. Polygamy

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05b

If married, how old were you when you got married for the first time? ...................

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06

Region of origin: 1 = West; 2 = Centre; 3 = Nord; 4 = South; 5 = East; 6 = Littoral; 7 = Adamawa; 8 = South-west; 9 = Nord-west; 10 = Far nord

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07

Place of residence: ………………………………

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