A Survey on Domestic Violence (DV) Against Woman
Email address *
Name (Optional)
Your answer
Contact no *
Your answer
Please give us the name of people that you scouted to participate the survey for our records
Your answer
1. Demographic
The following items will be used for classification purposes only. Your responses will be treated confidentially. You can tick your sincere response and the closest answer for each question.
Please select the category that includes your age *
Please select the category that describes your marital status *
Which one of the following category describes your highest level of education *
Which one of the category describes your employment status *
Please indicate your monthly Income (RM) *
Please state your number of children *
Please indicate your race *
Please indicate your religion *
Revert to Islam *
Please select the category that includes your spouse/partner age *
Which one of the following category describes your spouse/partner highest level of education *
Which one of the category describes your spouse/partner employment status? *
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