Women Entrepreneur Registration

Enumerator Details

Surveyor Name*

Personal Information

Street vendor name (As per Aadhaar)*

Date of Birth*

Age

Age Bracket:

Gender*

Mobile No.*

Alternative Mobile Number

E-Mail ID

Marital Status*

Aadhaar UID Number*

Identity Proof (PAN Card/Aadhaar Card/Voter ID)* Accepted formats: JPEG, PNG, JPG Max size: 2MB Front

Identity Proof (PAN Card/Aadhaar Card/Voter ID)* Accepted formats: JPEG, PNG, JPG Max size: 2MB Back

Family Head Name*

Family Head Relation*

Family Head Occupation*

Family Annual Income*

Type of Ration Card*

Ration card proof* Accepted formats: JPEG, PNG, JPG Max size: 2MB

Emergency Contact Mobile No*

Relationship*

Additional Information

Religion

Caste

Do you have a smartphone?*

Is Father/Spouse/Guardian involved in street vending for livelihoods?*

Udyog Aadhaar Number (if available)

Mobile Number Linked With*

Father's Primary Occupation*

Mother's Primary Occupation*

Number of Currently Earning Members in Household*

Sources of Household Income*

Household Information

S.No.	Relationship	Member Name	Occupation	Monthly Income (₹)	Action
1

Group Membership

Do you belong to any group?*

Address Information

Present Address

House & Floor No.*

Street/Block/Sector*

Pin Code*

Village/Town/City*

State

District*

Permanent Address

Same as Present Address

House & Floor No.

Street/Block/Sector

Pin Code

Village/Town/City*

State

District

Educational Qualifications

Please provide your educational qualifications.

Please add highest qualification first

S.No.	Standard*	Board/University	Passing Year	Marks Obtained	Percentage (%)	Action
1

Enterprise Profile

Are you currently running a business?*

Total Average Monthly Household Income (₹)*

Do you maintain income/expense records?

Is your business registered?

Have you availed any government scheme?

Is your business bank account linked to UPI?

Is this account used for business transactions?

Business Finance

Have you ever taken a business loan?*

Needs & Challenges

What support do you need to expand?*

Main challenges in expanding/setting up enterprise*

Who primarily decides how money is spent in the household?*

Do you independently manage your business income?*

Do you have a bank account in your own name?*

If primary income stopped for 1 month, how many days could household manage?*

Does any household member have savings set aside for emergencies?*

Skills Training Preferences

Skills Training Program of Interest*

Preferred Training Time*

Financial Inclusion

Please provide details about financial inclusion below.

Do you have a savings account in a bank or post office?*

Documents Proof

Please upload the required documents below.

Candidate Photo* Accepted formats: JPEG, PNG, JPG Max size: 2MB

Education Qualification Proof Accepted formats: JPEG, PNG, JPG, PDF Max size: 2MB

Street Vendor Register

Women Entrepreneur Register

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