Data Gathering Instrument for Trainee’s Characteristics

Name: _______________________________________ Date: _____________

Qualification: _________________________________

Instruction:
Please answer the following instrument according to the characteristics described
below. Encircle the letter of your choice that best describes you as a learner. Blank spaces
are provided for some data that need your response.

Characteristics of Learners
Language, literacy and Average grade in: Average grade in:
numeracy (LL&N) English Math
a. 95 and above f. 95 and above
b. 90 to 94 g. 90 to 94
c. 85 to 89 h. 85 to 89
d. 80 to 84 i. 80 to 84
e. 75 to 79 j. 75 to 79

Cultural and language Ethnic group: Language Spoken:

background a. Tagalog Please specify:
b. Cebuano __________________
c. Ilocano __________________
d. Hiligaynon __________________
e. Bicolano __________________
f. Waray
g. Moro Tribal group: if any
h. Others: please specify __________________
________________
Education & general Highest Educational Attainment:
knowledge a. High School Level
b. High School Graduate
c. College Level
d. College Graduate
e. with units in Master’s degree
f. Masteral Graduate
g. With units in Doctoral Level
h. Doctoral Graduate
Sex a. Male
b. Female
Age Your age: _____

Physical ability I. Disabilities (if any) _____________________

II. Existing Health Conditions (Existing illness if any)
a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
f. Diabetes
g. Others(please specify) __________________
 Characteristics of Learners
Previous experience Trainers Methodology Level 1 Certificates
with the topic a. Vocational Trainer
b. Teacher
c. Professor
Number of years in the job related to TM1______
Previous learning List down trainings related to TM1
experience a. Others (please specify) __________________
Training Level National Certificates acquired and NC level
completed a. TQAQ
b. TM/AM
c. Others (Please specify) _______________
Special courses Other courses related to Trainers Methodology Level 1
a. ASEAN MRA-TP
b. Training Delivery Courses
c. Others (Please specify) __________________

Learning style a. Visual - The visual learner takes mental pictures of

information given, so in order for this kind of learner to
retain information, oral or written, presentations of new
information must contain diagrams and drawings,
preferably in color. The visual learner can't
concentrate with a lot of activity around him and will
focus better and learn faster in a quiet study
environment.
b. Kinesthetic - described as the students in the
classroom, who have problems sitting still and who
often bounce their legs while tapping their fingers on
the desks. They are often referred to as hyperactive
students with concentration issues.
c. Auditory- a learner who has the ability to remember
speeches and lectures in detail but has a hard time
with written text. Having to read long texts is pointless
and will not be retained by the auditory learner unless
it is read aloud.
Other needs a. Financially challenged
b. Working student
c. Solo parent
d. Others(please specify) _________________________

Prepared by:

Mr. Jaewe Piansay

TM1 Trainer