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KK PROFILING ANNEX 3 Draft

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44 views1 page

KK PROFILING ANNEX 3 Draft

Uploaded by

joelmalatemontecillo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Province of Davao del Sur


Municipality of Padada
BARANGAY HARADA BUTAI

OFFICE OF THE SANGGUNIANG KABATAAN

KK Survey Questionnaire Respondent #:


Date:
TO THE RESPONDENT:
Good day!
We are currently conducting a study that focuses on assessing the demographic information of the
Katipunan ng Kabataan. We would like to ask for your participation by taking your time to answer this
questionnaire. Please read the questions carefully and answer them accurately.
REST ASSURED THAT ALL INFORMATION GATHERED FROM THIS STUDY WILL BE
TREATED WITH UTMOST CONFIDENTIALITY.

I. PROFILE
Name of Respondent:
First Name Middle Name Last Name Suffix

Location:
Region Province City/Municipality Barangay Purok/Zone
Sex
Male Age: _____________ E-mail Address: ___________________
Assigned
by Birth:
Female Birthday: ______________ Contact #: ____________________
[dd/mm/yyyy]

II. DEMOGRAPHIC CHARACTERISTICS


Please put a Check mark next to the word of Phrase that matches your response
Civil Status: Youth Classification:
Single Separated [ ] In school Youth [ ] Person w/ Disability
Married Annulled [ ] Out of School Youth [ ] Children In Conflict
Widowed Unknown [ ] Working Youth with Law
Divorced Live-in [ ] Youth with specific needs: [ ] Indigenous People
Youth Age Group: Work Status:
[ ] Child Youth (15-17 yrs old) [ ] Employed [ ] Currently looking for a job
[ ] Core Youth (18-24 yrs old) [ ] Unemployed [ ] Not interested looking for a job
[ ] Young Adult (25-30 yrs old) [ ] Self-Employed
Educational Background: Registered SK Voter? Have you already
[ ] Elementary Level [ ] Yes attended an SK
[ ] Elementary Graduate [ ] No Assembly?
[ ] High School Level [ ] Yes
[ ] High School Graduate Registered National Voter? [ ] No
[ ] Vocational Graduate [ ] Yes
[ ] College Level [ ] No If Yes, How many
[ ] College Graduate times?
[ ] Masters Level Did you vote last SK Election? [ ] 1-2 Times
[ ] Masters Graduate [ ] Yes [ ] 3-4 Times
[ ] Doctorate Level [ ] No [ ] 5 and Above
[ ] Doctorate Graduate
If No, Why?
[ ] There was no KK
Assembly Meeting
[ ] Not Interested to
Attend
Name and Signature of Participant

Thank you for your Participation!

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