SIYB CLIENT ENTRY FORM

Please transfer data to the ToE Activity Report form and in additional to submitting a copy to ILO, send a copy of the complete report to your SIYB
Training Service Facilitator.

I. Client information (This form received on: ____. ____. ____ )

1. Your name: 2. Sex: Male Female Other

3. Your address (business or personal): 4. Age: _ _ 16 – 25 36 - 45
26 - 35 46 – 60
> 60
5. Email: 6. Faxnumber: 7. Telephone:
8. Your highest education completed: 9. How would you rank your abilities to read and write in the
seminar language and do simple calculations?

Elementary  Excellent  Fair

College Higher
 Good  Weak
Please specify: __________

10. Currently, what is your main occupation? (select all that apply to you)
full-time employed in public sector full-time self-employed / own business
part-time employed in public sector part-time self-employed (own business)
full-time employed in private sector farming
part-time employed in private sector retired
unemployed, previously employed in public sector school leaver
unemployed, previously employed in private sector
unemployed, previously self-employed / own business
11. What is your average monthly family income? (in local 12. Have you attended SIYB training before?
currency)

None IYB
GYB EYB
SYB Any other combination,
please specify __________________

13. Have you attended any skills training related to your 14. Have you attended any business management courses before?
business?
Yes No Yes No
If yes please specify: __________________________ If yes please specify: ______________________________________

How long was the training?: _____________________ How long was the training?: _______________________________
II. Existing Business owners
21. Name of your business: 22. When did you start the business?
Less than 1 year ago
More : first commercial month: ___ . ___
(mm.yy)

23. What is your position in the business? 24. Describe your business activity:

Owner / manager
Owner / not manager
Shared owner
Employee / coop member

25. What is your current line of business? 26. What type of business is it?
Retail Service Operation Sole Proprietorship
Wholesale Agriculture related Partnership
Manufacturing Other (specify): ___________________ Cooperative
Joint Stock Company
Other (specify): ___________________

27. Is your business registered? Yes No

28. What is the average monthly sales of your business? 29. How much is the monthly net profit of
the business?

30. How many people do you employ?: ____employees (excluding the owner) out of which _____women; please specify:
Mostly full time employees, all paid a salary Mostly full time employees, not all paid a salary
Mostly part time workers, all paid a salary Mostly part time workers, not all paid a salary
Mostly family members, paid a salary Mostly family members, not all paid a salary

31. How do you judge the status of the following Good Fair Weak N/A
practices in your business? No Counselling session Counselling Information
improvement required session session
(please tick ►)
necessary required required
- salary levels of employees
- written contracts for employees
- health and accident insurance
- pensions scheme
- annual leave arrangements for employees
- sick leave
- parental leave
- training,apprenticeship and other opportunities for
employees
- occupational safety and health
-absenteeism
Index
32. Do you perform any of the below mentioned task in Regularly = Sometimes = Fair Seldom= N/A = Never
your business? Good Counselling session Weak Information
No required Counselling session
improvement session required
necessary required

- Marketing activities to sell your products?

-Calculating your costs before setting selling prices?
-Make a cash flow plan
-Make a sales and cost plan
 -Recording keeping system
-Buying and stock control
-Any form of human resource management
Index

33. Does your business have access to finances? If yes, please specify:

Governmental or non-governmental organizations;

Banks that have a small business window;
National and international donor development agencies;
Credit unions / cooperatives;
Community programmes
Other, please identify: _______________________________
34. Do you have more than one business?
No Yes

If yes, Please specify:__________________________________________________________________________________________________________________

35.What are your plans for your existing business in the near future?
Remain with / strengthen same business Start new business activities in addition to existing one
Start new business, replacing old one Dont know
36. Will you be able to plan for a new business/new business activity within the existing business?
No Yes

III. Training expectations and training needs

37. What do you expect to learn during the training?
1.

2.

END  Use the SIYB Selection Tree to determine the type of SIYB training appropriate for the applicant

Advice:
Client to attend [ GYB / SYB / IYB / EYB ] seminar planned for ____. ____. ____ (starting date) to be conducted by trainer ______ . ______ .