LANGO SUB-REGION

Data collection template

District: ______________________________ ONC Officer ________________________________________ Signature: ___________________________

Date Department Name of the officer in Designation Phone contact Academic Supervisor Phone Contact of
charge qualification the supervisor
 LANGO SUB-REGION
Government Program: __________________________ District ___________________ Program Officer ________________ Phone No ________________

SACCOS Sub county Parish Village /LC1 Amount of money Date received Money in
received (UGx) circulation/Used/Ugx
LANGO SUB-REGION