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IMO STATE FEMALE STUDENTS EMPOWERMENT FORM

PERSONAL INFORMATION

The GoodHope Women Flourish Initiative (GHWFI), an initiative founded by Her Excellency, Barr. Chioma Uzodimma, the First Lady of Imo State, is implementing a Women’s month empowerment programme designed to support women and girls in Imo State through skills acquisition training, mentorship, and selected livelihood support. This survey form is designed to help the Foundation to map interested beneficiaries across Imo State, thereby ensuring fair and equitable selection. Kindly complete the form accurately. Only one entry per female student is accepted, as multiple submissions will result in disqualification. Submission does not automatically guarantee selection. Beneficiaries will be shortlisted based on eligibility and spread across the Local Government Areas/Zones in Imo State.
1.What is your name?(Required.)
2.What is your age bracket?(Required.)
3.Institution (Tick as applicable)(Required.)
4.Course of Study(Required.)
5.Year/Level(Required.)
6.Local Government Area in Imo State(Required.)
7.Are you a person with disability(Required.)
8.If yes to (7), please describe further and indicate what kind of assistance you may require(Required.)