BORROWER INFORMATION Name: 1. Center: 2.

Group:

3. Municipality or community: 4. Type of business:

Please respond briefly and honestly: 5. How old are you? _______________ 6. Marital status: a. Single b. Married c. Separated d. Widow e. Divorced f. Common law marriage 7. Education level completed: a. None b. Elementary c. Junior high school d. High school e. College/BA f. Technical degree g. Other _____________________ 8. Exactly how many years of school did you attend? _____ 9. Exactly how many years of school has your oldest child attended (or your child with the most years of schooling)____ 10. Do you speak an indigenous language or dialect? Yes___ No ___ 11. Which one? Yaqui____ Mayo____ Other (Please write which one)______ 12. Do your parents or grandparents speak an indigenous language or dialect? 13. Which one? Yaqui____ Mayo____ Other (Please write which one)______ 14. Do your children speak an indigenous language or dialect? Yes___ No ___ 15. Which one? Yaqui____ Mayo____ Other (Please write which one)______ 16. Number of children : _________________________ 17. Your children go to: Elementary school____ Junior HS____ High school___ College____

18. Are you receiving any scholarships for your own education? Yes___ No___ 19. What kind of scholarship(s)? From GDLF ___ From another source___ (Which source?)________ 20. For what level of education? Elementary____ Junior HS____ HS___ College____ (write course of study):_________________ 21. Are you receiving any scholarships for your children? Yes___ No____ 22. What kind of scholarship(s)? From GDLF ___ From another source___ (Which source?)________ 23. For what level of education? Elementary____ Junior HS____ HS___ College____ (write course of study):_________________ 24. The house where I live is: a. Mine b. Rented c. Lent to me d. Other: 25. Your house has full indoor plumbing: Yes___ No___ 26. Your house has running water: Yes___ No___ 27. Your house has electricity: Yes___ No___ 28. Your house has a telephone: Yes___ No___ 29. Your house has internet: Yes___ No___ 30. Does your husband have steady employment? Yes___ No___ 31. How much does your husband earn each month? _______ 32. Does your family have medical insurance? Yes___ No__ 33. What kind of medical insurance does your family have? a. Basicpublic insurance b. Private insurance c. Insurance through the company where your husband works d. Insurance through the company where your son/daughter works e. Insurance through the company where you work f. Other (what):____ g. None 34. Number of months since joining theGDLF program: _____ 35. Number of loans received from GDLF: ______ 36. Exact amount of the last microcredit received:________________ 37. How did you find out about GDLF loans? a. Though a friend or relative b. Through a representative c. Through the radio, TV, a magazine or newspaper d. Through another financial agency e. Through a teacher, doctor, counselor, community leader, etc. f. Other (write whom) _______ 38. According to what you have understood up till now, where does the money come from for GDLF loans? a. The government b. The church (which one):____ c. A political party (which one):_____ d. Entrepreneurs from the United states e. Entrepreneurs from Mexico f. Entrepreneurs from Mexico and the United States

g. h. i.

Civil associations and international agencies Universities Other (what):____________

39. When you received the loan money for the first time, what percentage of the loan did you use for family expenses (food, utilities, rent, the purchase of home appliances, gasoline, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 40. When you received the loan money for the first time, what percentage of the loan did you use to invest in your business (to purchase supplies, gasoline, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 41. When you received the loan money for the first time, what percentage of the loan did you save immediately? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 42. When you received the loan money for the first time, what percentage of the loan did you use to pay for school expenses (tuition, inscription fees, transportation, supplies, uniforms, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 43. When you received the loan money for the first time, what percentage of the loan did you use immediately for health expenses (medicine, doctors, transportation to the hospital, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 44. When you received the loan money for the first time, did you use the money to make home improvements? Yes____ No____

45. What percentage? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 46. In what way? a. Purchased and installed flooring b. Installed plumbing c. Purchased air conditioning d. Purchased a television e. Got a telephone line f. Enlarged bedrooms g. Purchased more land h. Paid lawyers, taxes or fees for the procedures concerning land, buying/renting a home, expansion, doing paperwork, etc. i. Others (please indicate type of expense) :____________ 47. With the last loan you received, what percentage of the money your business generates monthly do you use for family expenses (food, utilities, rent, the purchase of home appliances, gasoline, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 48. With the last loan you received, what percentage of the money your business generates monthly do you use to reinvest in the business (the purchase of supplies, gasoline, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 49. With the last loan you received, what percentage do you save of the money your business generates monthly? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All 50. With the last loan you received, what percentage of the money your business generates monthly do you use to pay for school)? a. None b. 25 % or less c. 25-50% d. 50-75%

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e. 75-100% f. All With the last loan you received, what percentage of the money your business generates monthly do you use for health expenses (medicine, doctors, transportation to the hospital, etc)? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All What percentage of the money your business generates do you use to improve or enlarge your home? a. None b. 25 % or less c. 25-50% d. 50-75% e. 75-100% f. All What do you feel you have learned thanks to becoming a GDLF borrower? (you can underline all that apply) a. Accounting b. To manage my business c. How to make my business known d. Making contacts to increase sales e. Legal aspects of business f. How to pay taxes g. About my type of business (raising goats, making cakes, indicate which):________________ h. Knowing how to manage employees i. Budgeting my money and planning production j. Reading and writing k. I finished my education (in what?):_____________ l. How to deal with family problems m. How to address authorities for personal gain or to benefit my business n. How to care for the environment o. How to apply for loans (not just with Grameen, but with other financial agencies) p. How to initiate a business plan q. Other (indicate what subject):_________________ When did you meet the people with whom you prepared and applied for the loan? a. I already knew them b. I met them when I applied for the microcredit. Complete this sentence using the phrase that you identify with most: After entering GDLF, and never before, a. I understood that I am capable of many things. b. I understand the value of not giving up. c. I am valuable to my community.

I feel secure about my financial future. I am sure that my children with finish their education. I pay attention to caring for the environment. I can decide what kind of work I want to do. I can stay in my place of origin without moving to another city to earn money. i. I can help my parents. j. I can help my family. k. I can help my children. l. I can buy myself things for my personal use and enjoyment m. I feel like I have women friends. n. I feel that I have protection. o. I can plan my financial future. p. Other:___________________________ (note: if you already felt this before you were a borrower, dont underline the phrase) 56. Please complete the sentence if you can identify with the phrase: Since I entered GDLF, and never before a. I feel anxiety and stress now that I have to pay the loan. b. I am afraid that my business will fail. c. I am afraid that my husband will get upset because I am an entrepreneur. d. I am afraid of not coming up with the money to pay the loan. e. my children have lost respect for me because I am an entrepreneur. f. I dont think I should be working, but that my husband, my parents or my children should support me. g. I feel that it is too much work for a little bit of gain. h. I feel alone with a very big responsibility. i. I dont feel that my business is valuable to the community. j. I feel like my business is bad for the environment. k. other:_________________________________________ (note: If you already felt this way before becoming a borrower, do not underline the phrase) 57. How do you picture your business in 5 years? a. I will no longer have the business b. The same c. Better, with more production and more clients. d. I will have several businesses by that time. 58. Now that you have your own business, which of the following do you feel sure that you will attain? a. Money for old age b. Money for my childrens education c. Money for my own education d. Amenities/conveniences (describe):__________ e. A better job in the future f. A united family g. Money to resolve medical problems h. Other:___________________________ 59. Do you feel that your business helps the environment? Yes___ No___ d. e. f. g. h.

60. In what way does your business help the environment? a. Recycling plastic, paper, etc. b. Using compost c. I dont pollute d. I sell nutritious food e. I organize and separate the garbage f. Other:___________________ g. Nothing. 61. Do you feel that your business helps to reduce crime in your community? Yes__No__ 62. Do you feel that your business helps young people to get off drugs and to stop loitering? Yes__No__ 63. Do you feel that your business helps the community to fight poverty? Yes__No__ 64. Do you feel that because of being an entrepreneur you should help other women in your community (to study, to start their own business, to avoid being abused, etc)? Yes__No__ 65. Do you feel that because of being an entrepreneur you should help your community to exercise their rights and to have more facilities (schools, pavement, utilities, etc)? Yes__No__ 66. Since becoming an entrepreneur do more people from the community approach you to ask for your advice or opinions when making decisions? Yes__No__ 67. Since becoming a GDLF entrepreneur, what changes have you seen in your family? a. My family is more united. b. My children respect me more. c. My husband respects me more. d. I can spend more time with my children. e. My husband listens to my opinions about family decisions. f. Now I can decide whether I will live alone or with my partner. g. My husband makes more effort to succeed. h. My daughters have more hope and self-esteem. i. We have resolved problems with drugs. j. We have resolved problems with alcoholism. k. We have resolved problems with violence. l. There havent been any changes in my family as a result of becoming an entrepreneur. m. Other comments:_______________________________ 68. What kind of training courses would you like to receive from GDLF? a. Accounting b. Taxes, how to register my business with the treasury department c. Legal aspects of my business d. Hygienic conditions in my business e. How to help the environment f. Managing employees g. Marketing, supply and demand, how to get more customers h. How to initiate projects with larger loans i. How to make a webpage for my business

Technical subjects (veterinary, mechanics, etc., indicate which subjects):________________________________________ k. How to avoid drug and alcohol addiction l. How to avoid obesity m. Domestic violence n. Prevention of unplanned pregnancy o. Relationships between couples p. Parenting classes q. How to read and write r. Computer courses s. How to apply for scholarships for yourself and your children with GDLF t. How to apply for scholarships for yourself and your children with other institutions u. Other __________________________ 69. What training courses would you like for GDLF to offer to students receiving its scholarships? (its preferable that you ask the student receiving the scholarship) a. Techniques for studying and concentrating b. Speed reading c. Writing d. Computer courses e. How to make a blog or webpage f. How to apply for undergraduate and postgraduate scholarships (options and requirements) g. How school loans work (whats available, how theyre paid for, etc.) h. How to avoid drug and alcohol addiction i. How to avoid obesity j. Domestic violence k. Prevention of unplanned pregnancy l. Relationships between couples m. Indigenous dialects (Yaqui, Mayo, etc.) n. Other __________________________

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