Questionnaire for a survey in Slums of
CHARKHI DADRI(Haryana)
Interview Date: _____
Serial No: ____
General Information
1. Interviewee Name
2. Gender
3. Place of Birth/Last Residence
4. Can you read/write?
5. Marital Status-
Married Unmarried
6. Do you have Children?
7. Are your Children staying with you?
8. Are you living with your family?
S. Head of No. of Relationship Marital Age Son Daughter Grandson Granddaughter Other
no. Household members with Head Status
in
Household
1.
2.
3.
4.
5.
9. Are you the only wager in your family?
10. Is your family dependent on you?
11. Are they working or dependent on you?
12. Is your Husband/Wife working?
13. Do you have any language problems in communicating locally?
14. Do you need to travel to your work location?
15. Do you work in the same city or other?
16. What is your commute time to work?
17. What means of transportation do you use?
Details about Migration
18. When did you migrate to this place?
19. What was the reason of migration?
20. Before coming to this place did you work in your native place?
21. Location of Slum:
City Area Periphery
21.1. When did you start living in this slum?
21.2. When did this slum come into existence?
21.3. How many families were already living in this slum when you settled here?
21.4. Why according to you this slum took place at this location of the city?
22. Do you still own your house at your native place?
23. How often do you visit that house?
24. Has anyone from your household/family moved away to live/work in another district or state?
25. Do you have any plans to send any of the family members to another location in the future?
26. If yes, why?
Economic Data
27. What is your Occupation?
Private Public Business Other
28. What type of job do you have?
Long-term Contractual Daily Wage Other
29. How long have you been working?
30. How did you find your current job?
Friends Relative Hired Other
31. Have you ever switched your job?
32. Are you planning to switch your job?
33. Will you prefer to move out of the city or locate somewhere else?
Quality of life
34. With increasing cost of living, are you able to sustain your livelihood?
35. Is there any MC clean drinking water supply operational in this slum?
36. If no, where do you get your water from?
37. Does any MC vehicle (of any type) visit this slum to collect household waste?
38. If yes, at what frequency?
39. If no, where do you dispose of your household waste?
40. Is there an electricity supply available in this slum?
41. If yes, how frequent are the electricity cuts in your area?
42. Do you think that government is doing something to improve living conditions in slum?
43. If yes, what are the slum development schemes and programs you are aware of?
44. Do you think that you or someone else living here in this slum got benefited by such schemes
and programs?
45. If yes, what are these benefits?
General comments (if any) -
