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Appendix E Sample Questionnaire Form
Appendix E Sample Questionnaire Form
Truly,
Checked by:
Instructions: Please put a check mark ( √ ) on the space provided corresponding to your
answer for each item. Choose only one.
I. Respondent’s Profile
Name (Optional): __________________
Gender
( ) Male
( ) Female
Age Bracket
( ) Below 21
( ) 21 – 30
( ) 31 – 40
( ) 41 – 50
( ) 51 and above
Occupation
( ) Student
( ) Employee
( ) Self-employed
( ) Others
For Working: Average Monthly Salary
( ) P10,000 and below
( ) P10,001 – P15,000
( ) P15,001 – P20,000
( ) P20,001 – P25,000
( ) P25,001 and above
For Students: Average Weekly Allowance
( ) P100 and below
( ) P101 – P150
( ) P151 – P200
( ) P201 – P250
( ) P251 and above
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