survey parish

To build a reliable, data-driven empowerment system, the baseline survey must collect actionable data without being overly intrusive. It is designed to capture both **needs** (who requires support) and **resources** (who can volunteer, mentor, or invest).

This comprehensive survey questionnaire can be distributed digitally (via Google Forms/KoboToolbox) or printed for door-to-door data collection by parish resource persons.

# PARISH EMPOWERMENT SYSTEM: BASELINE SURVEY

**Confidentiality Note:** *The data collected in this survey will be used exclusively for the welfare, pastoral care, and socio-economic empowerment initiatives of the Parish/Diocese. It will not be shared with externa

l commercial entities.*

## SECTION 1: BASIC DEMOGRAPHIC & HOUSEHOLD DATA

**1.1 Household General Information**

 * **Parish Ward/Unit Name:** ___________________________

 * **House Name & Number:** ___________________________

 * **Family Registered Name (Family Roll No.):** ___________________________

 * **Head of the Family Name:** ___________________________

 * **Primary Mobile Number:** ___________________________

 * **WhatsApp Number (if different):** ___________________________

 * **Email Address:** ___________________________

**1.2 Household Composition Matrix**

*Please list all members currently living in the household, as well as unmarried children or family members living elsewhere temporarily (e.g., students).*

| No. | Member Name | Relationship to Head | Gender (M/F/O) | Age | Education Level | Current Occupation / Status (Student, Employed, Retired, etc.) | Resident Status (Local / NRI / Other State) |

|---|---|---|---|---|---|---|---|

| 1 |  | *Head* |  |  |  |  |  |

| 2 |  |  |  |  |  |  |  |

| 3 |  |  |  |  |  |  |  |

| 4 |  |  |  |  |  |  |  |

| 5 |  |  |  |  |  |  |  |

## SECTION 2: FOCUS AREA PROFILING (THE 13 PILLARS)

### Pillar A: Senior Citizens & Weaker Sections (Care & Inclusion)

**2.1** Are there senior citizens (Age 60+) residing in this home?

 * [ ] Yes

 * [ ] No *(If No, skip to 2.4)*

**2.2** If yes, do any of them require specialized assistance? *(Check all that apply)*

 * [ ] Regular medical/health check-up facilitation

 * [ ] Assistance with digital tools (Online banking, smartphone usage, utility bills)

 * [ ] Local transportation assistance for medical/church needs

 * [ ] Companionship/Home visits (Living alone or alone during day hours)

 * [ ] Guidance on senior citizen government welfare schemes/pensions

**2.3** Is anyone in the household living with a permanent physical/mental challenge or chronic illness requiring community support?

 * [ ] Yes (Details optional: ___________________________)

 * [ ] No

**2.4** Does the family currently require support to access basic government welfare programs? (e.g., housing schemes, subsidized medical care, minority educational grants)

 * [ ] Yes

 * [ ] No

### Pillar B: Job Seekers, Career Guidance & Youth

**3.1** Is there anyone in the household currently **actively looking for employment**?

 * [ ] Yes

 * [ ] No *(If No, skip to 3.4)*

**3.2** If yes, please provide details for the job seeker(s):

 * **Name(s):** ___________________________

 * **Highest Qualification:** ___________________________

 * **Area of Interest/Sector:** [ ] IT/Tech [ ] Government Sector [ ] Skilled Trade/Technical [ ] Nursing/Healthcare [ ] Management/Admin [ ] Teaching [ ] Other: __________

 * **Type of assistance needed:** [ ] Job alerts [ ] Skill development/Upskilling [ ] Resume writing/Mock interviews [ ] PSC/UPSC exam coaching

**3.3** Are there students in the household (Classes 9 to 12 or College) who require professional **Career Guidance or Mental Health Counselling**?

 * [ ] Yes, Career Guidance

 * [ ] Yes, Personal Counselling

 * [ ] No

**3.4** Are the youth (Ages 15–30) in this family active in institutional **Alumni Associations** or former student networks?

 * [ ] Yes (Name of institutions: ___________________________)

 * [ ] No

### Pillar C: Businessmen & Professionals (The Resource Pool)

**4.1** Does any member of the household own or operate a business?

 * [ ] Yes

 * [ ] No *(If No, skip to 4.4)*

**4.2** If yes, what is the nature of the business?

 * [ ] Retail/Trading [ ] Agriculture/Plantation [ ] Manufacturing [ ] Service Industry [ ] Construction/Real Estate [ ] IT/Digital Agency [ ] Other: __________

**4.3** Would the business owner be interested in joining a **Parish/Diocesan Business Network** for peer mentoring and collaborative growth?

 * [ ] Yes

 * [ ] No

 * [ ] Maybe

**4.4** Are there working professionals in the house (e.g., Doctors, Engineers, Lawyers, Charted Accountants, Land Consultants, Teachers, Management Executives)?

 * [ ] Yes

 * [ ] No

 * *If yes, please specify names and professions:* ___________________________

### Pillar D: NRI (Diaspora) & Matrimony

**5.1** Are any immediate family members currently residing **abroad (NRIs)**?

 * [ ] Yes

 * [ ] No *(If No, skip to 5.4)*

**5.2** If yes, which country/countries? ___________________________

**5.3** What type of support can the parish provide to your family members abroad or to you on their behalf? *(Check all that apply)*

 * [ ] Property management/asset oversight assistance

 * [ ] Local administrative/government liaison support for elderly parents left behind

 * [ ] Emergency local contact system

 * [ ] Networking opportunities with diocesan chaplancies abroad

**5.4** Is anyone in the household looking for matrimonial alliances?

 * [ ] Yes

 * [ ] No

 * *If yes, is the individual registered with the Diocesan Matrimony portal?* [ ] Yes [ ] No

## SECTION 3: SKILLS INVENTORY & COMMUNITY CONTRIBUTION

*(Crucial for Phase 2 & 3: Finding resource persons within the pews)*

**6.1** In which of the following areas can members of your household contribute their **time, expertise, or influence** to empower the parish community? *(Select all that apply and write the family member's name next to it)*

 * [ ] **Career Mentoring / Teaching / Exam Coaching** (Name: ______________)

 * [ ] **Job Placements / Providing Job Referrals** (Name: ______________)

 * [ ] **Business Mentorship / Entrepreneurship Guidance** (Name: ______________)

 * [ ] **Legal, Financial, Tax, or Property/Asset Management Advice** (Name: ______________)

 * [ ] **Liaison Support** (Helping parishioners navigate Government Offices/NGOs) (Name: ______________)

 * [ ] **Senior Citizen Care & Visitation Volunteering** (Name: ______________)

 * [ ] **Youth Leadership / Sports / Cultural Coordination** (Name: ______________)

 * [ ] **Counseling / Mental Health Support / Crisis Management** (Name: ______________)

**6.2** How much time can your family collectively volunteer for parish empowerment initiatives?

 * [ ] 1–2 hours per week

 * [ ] 2–5 hours per month

 * [ ] On-call for specific emergency/professional needs only

 * [ ] Unable to volunteer time at present

## SECTION 4: ASSET MANAGEMENT & CONNECTIVITY (Feedback)

**7.1** Do you feel the current communication and interpersonal connectivity within the parish infrastructure needs improvement?

 * [ ] Yes, heavily dependent on traditional announcements. We need a digital/direct network.

 * [ ] It is satisfactory but can be modernized.

 * [ ] It is excellent.

**7.2** Do you have any specific suggestions on how the parish can better utilize its collective assets (halls, unused land, human networks) or coordinate with local Government/NGOs to empower families?

 *  * **Date of Survey:** DD / MM / YYYY

**Name & Signature of Surveyor (Resource Person):** ___________________________

**Signature of Family Representative:** ___________________________

## Instructions for Resource Persons (Data Management SOP)

 1. **Preparation:** Before visiting, pre-fill basic data like the Ward/Unit name and Family Roll number if available from the parish register to save time.

 2. **The Pitch:** Explain clearly that this is **not** a census for taxation or mandatory collections. Frame it as a "Talent and Needs Mapping" to ensure no family is left behind during crises or job searches.

 3. **Data Entry:** Once physical forms are collected, group them by Ward. Transfer the data into the central **Parish Empowerment Digital Dashboard** within 7 days.

 4. **Action Item Routing:** Immediate red flags (e.g., an isolated senior citizen requiring medical access, or an urgent employment crisis) must be filtered and routed to the respective *Parish Functional Cell* immediately without waiting for the entire survey project to conclude.