Survey Form

COED Students:
Greetings! How are you? We hope and pray that you and your family are safe amid these trying times.
We request you to accomplish completely this online registration and survey form as we check your
academic records for the purpose of advising. We are all aware that your health and safety are our priority
and we want you to know that we are in this together. We adhere to the statement "We Learn as One".
The first part of this form pertains to the information necessary for the process of advising, hence, we
seek your consent to disclose us the needed data, The second part gathers essential details for the conduct
of Flexible Learning, Thank you and God bless.
Required
Registration
Please fill-up completely each item. Thank you.

Last Name 11. Type of internet connectivity you have at

___________________________ home:
2. First name
___________________________ DSL
3. Middle Fiber
name___________________________
4. Previous Course Wireless Broadband
________________________
Mobile Data
Major
12. Internet Speed
________________________
5. Sex 1 Mbps and below
Female 2-3 Mbps
Male 3-5 Mbps
6. Student I.D Number (for the second year to
fourth-year students) Note: For the incoming 6-10 Mbps
first-year students, please type N/A 11-15 Mbps
_________________________
7. Mobile Number (11-digit, e.g. 09091010120) 16-20 Mbps
21 Mbps and above
_______________________________
13. Status of Internet Connection
8. Active Email Address
Highly Stable
_______________________________
9. Address during the conduct of flexible Stable
learning Poor
10. Available learning device/s that can be
used Very Poor
Laptop None at all
14. Do you have prior experience in using any
Desktop Computer type of Learning Management System (LMS)
Android Phone (e.g. EDMODO, Google Classroom, MS
Teams, etc.)
Table
Yes
None
No