THE FIRST OF ITS KIND “ NON- ACADEMIC” HYBRID EDUCATIONAL PLATFORM
FOCUS ON
MENTAL HEALTH. PARENTING. LIFE SKILLS. SUSTAINABILITY
Select Your Category
Pre School
Schools
Colleges
Corporates
Gated Communities
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QUESTIONNAIRE TOWARDS
IDENTIFYING VULNERABILITY. HELPING IN EARLY INTERVENTION.
Age Group (Years)
Please Select Age Group
3-5
6-8
9-11
12-18
18-30
18-30
31-65
3-5
6-8
9-11
12-18
18-30
31-65
Full Name
Age
Gender
Please Select Your Gender
Male
Female
Non-binary/Third gender
Prefer not to say
Pre School Name
Please Select School
Bachpan Pre School
Euro Kids
Footprints Pre School
Jumbo Kids
Kidzee Pre School
Klay Pre School
Kmv Red Hills Kindy
Koala Pre School
Little Elley Pre School
Maple Bear
Podar Jumbo Kids
School Name
Please Select School
Aurobindo School
Baldwin Boys’ High School
Baldwin Girls’ High School
Bangalore Military School
Bethany’s High School
Bishop Cotton Boys’ High School
Bishop Cotton Girls’ High School
Carmel School
Dayanand Sagar Public School
Dps East
Dps North
Dps South
Dps Whitefield
Ekya Schools
Greenwood High International
Hill View Public School
Indus International School
Inventure Academy
Jain Heritage School
Jain I Public School
Jain International Residential School
Little Flower Public School
Magnifique English School
Mallya Aditi International School
National Hill View Public School
National Public School
Nurture International
Orchid International
Orchid Public School
Rcis
Ryan International School
Sherwood High School
St. Joseph’s Boys High School
Tapas
Vibgyor Public School
Vidya Sagar Public School
Vidyashilp Academy
Student Class/Grade
Section
Please Select Section
A
B
C
D
E
F
G
H
I
J
K
Not Applicable
College Name
Please Select College
Christ College
Dayanand Sagar
Jyoti Nivas College
Kle
Mount Carmel College
Rv College
Srinivas University
St. Joseph’s Arts And Science
St. Joseph’s Commerce
Name of the Organisation
Please Select Organisation
Amazon
Biocon
Capgemini
Cisco
Cognizant
Freyssinet Menard India
Google
HP
IBM
ISRO
ITC Infotech
Infosys
Innovatily Private Limited
Intel
Intuit
Kotak Health Insurance
Kotak Life Insurance
Oracle
Prestige Group
Sap Labs
Swiggy
Syngene
TCS
Target
Wipro
Designation
Gated Community Name
Please Select Gated Community
Adarsh
Brigade
Casagrand
Embassy
Godrej
Heritage County
Mantri
Prestige
Purvankara
RNS
RNS Shanthi Nivas
Sattva
Shoba
Shriram
Vasvani
Windsor Four Seasons
Course
Please Select Course
Bachelors
Masters
Diploma
PhD
Others
Marital Status
Please Select Marital Status
Single
In a relationship
Married
Divorced
Widowed
Average Daily Personal Screen Time (hours)
Please Select Average Daily Screen Time
Less than 1 hour
1-3 hours
4-6 hours
7-9 hours
10 hours or more
Form filled by
Please Select Any Option
Father
Mother
Both
Other
Mother's Name
Email Id
Phone number
City
Please Select City
Bengaluru
Father's Name
Email Id
Phone number
City
Please Select City
Bengaluru
Guardian's Name
Email Id
Phone number
City
Please Select City
Bengaluru
Spouse's Name
Email Id
Phone number
City
Please Select City
Bengaluru
Self Name
Email Id
Phone number
City
Please Select City
Bengaluru
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QUESTIONNAIRE TOWARDS
IDENTIFYING VULNERABILITY. HELPING IN EARLY INTERVENTION.
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