QUESTIONNAIRE ON DISASTER PREPAREDNESS OF SENIOR HIGH

SCHOOL STUDENTS IN TANDOC NATIONAL HIGH SCHOOL

Name (optional):_________________________________

Please check the box that corresponds to your answer

Gender: Grade level:

Male 11

Female 12

Instruction: Read each statement and put check (/) in the appropriate box to indicate
your level of disaster preparedness. You have five (5) choices for each statement as
follows:

5-Always 4-Often 3-Sometimes 2- Rarely 1-Never

The purpose of this form is to know your level of disaster preparedness, please respond
as honestly and sincerely as possible.

Typhoon 5 4 3 2 1
I get rid of dead and rotting trees
that could fall in our house before
the typhoon strikes.
I have signed up with the entities
that provide emergency news about
typhoon.
I am prepared with emergency bags
that contain instant food and
important documents.
I ensure the safety of our home
before the typhoon occurs.
I watch news for weather updates.
I am aware of the evacuation in our
area.
I keep flashlights, candles and
battery-powered radios within easy
reach.
I secure domesticated animals in a
safe place.
I make a plan for staying in touch
with my family during a typhoon.
I am familiar with the signal warning.
Earthquake
We discussed in family where the
meeting place is if an earthquake
occur.
I know the earthquake plan of our
school.
I practice drop, cover and hold.
I participate in earthquake drill.
I secure heavy objects in a secured
shelf.
I keep flammable or hazardous
liquids in cabinet or in lower shelves.
I secure appliances that could move
enough to rupture lines.
I have a list of emergency phone
numbers in case the earthquake
occur.
I know how to find the emergency
exit in a building when an earthquake
strikes.
I know the safety spots in our area.
Thunderstorm
I watch news for thunderstorm
advisory.
I unplug any electronic equipment
well before the thunderstorm arrives.
I get rid of dead or rotting trees that
could fall during a thunderstorm.
I am aware that rubber-soled shoes
and rubber tires provide NO
protection from lightning.
I am familiar with the color warning
of thunderstorm.
I am prepared with emergency kit
and family communication plan.
I make myself aware about the
incoming thunderstorm.
I have a list of emergency phone
numbers in case thunderstorm
strikes.
I ensure the safety of our home
before the thunderstorm occurs.
I secure mirror or any other objects
that may hit by the light of the
thunderstorm.