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KK Survey QuestionnaireRespondent #: ____________
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Date: ________________
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TO THE RESPONDENT:
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Good day!
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We are currently conducting a study that focuses on assessing the demographic information of the Katipunan ng Kabataan. We would like to ask your participation by taking your time to answer this questionnaire. Please read the questions carefully and answer them accurately.
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REST ASSURED THAT ALL INFORMATION GATHERED FROM THIS STUDY WILL BE TREATED WITH UTMOST CONFIDENTIALITY.
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I. PROFILE
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Name of Respondent: ______________________________________________________________________________
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Last Name
First Name
MIddle Name
Suffix
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Location: _________________________________________________________________________________________
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RegionProvince
City/Municipality
Baranggay
Purok/Zone
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Sex Assigned by Birth:Male
Age: ______________________
E-mail address: _____________________
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FemaleBirthday: __________________
Contact #: _________________________
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(dd/mm/yy)
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II. DEMOGRAPHIC CHARACTERISTICS
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Please put a Check mark next to the word or Phrase that matches your response.
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Civil StatusSingle
Separated
Youth Classification
In school Youth
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MarriedAnnulled
Out of School Youth
Person w/ Disability
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Widowed
Unkown
Working Youth
Children In Conflict
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DivorcedLive-in
Youth w/ Specific needs:
w/ Law
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Indigenous People
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Youth age Group
Child Youth (15-17 yrs old)
Work StatusEmployed
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Core Youth (18-24 yrs old)
Unemployed
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Young Adult (15-30 yrs old)
Self-Employed
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Currently looking for a Job
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Not Interested Looking for a Job
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Educational Background
Elementary Level
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Elementary Grad
Registered SK Voter?YesDid you vote last SK election?Yes
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High school level
NoNo
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High school Grad
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Vocational Grad
Registered National Voter?YesIf Yes, How many times?
1-2 Times
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College Level
No
3-4 Times
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College Grad
5 and above
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Masters Level
Have you already attended a KK Assembly?Yes
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Masters Grad
NoIf No, Why?
There was no
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Doctorate Level
KK Assembly Meeting
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Doctorate Graduate
Not Interested
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to Attend
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Thank you for your participation!
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Name and Signature of Participant
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