JOY OF GOD ORPHANAGE CHILD DATA COLLECTION FORM

Section A: Personal Information

Full Name: Glory Alex Japhet

Date of Birth: 30/12/2021

Age: 4

Gender: Female

Place of Birth: CDB Arusha

Short Background/Story

Both of her parents are sick and live in poor social conditions. They are HIV positive. She comes from a difficult family background and was brought to social welfare.

Section C: Education Information

Current School:

Class/Grade:

School Performance (Last Exam Grade/Remarks):

Section D: Health Information

Known Medical Conditions:

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: She Don’t have