JOY OF GOD ORPHANAGE CHILD DATA COLLECTION FORM

Section A: Personal Information

Full Name: Ester Lazaro Mhembo

Date of Birth: 17/02/2010

Age: 15

Gender: Female

Place of Birth: Kongwa Dodoma

Short Background/Story

She is an orphan; both her father and mother had passed away, and she was brought in by the social welfare.

Section C: Education Information

Current School: Kaloleni

Class/Grade: Form One

School Performance (Last Exam Grade/Remarks):

Section D: Health Information

Known Medical Conditions: NIL

Allergies: NIL

Disability (if any): NIL

Vaccination Status: I don’t know

Section E: Sponsorship Information

Type of Sponsorship:

   • Education: 0%

   • Health: 0%

   • Food/Nutrition: 0%

   • Clothing: 0%

Other: He Don’t have