Name: Date:

Sample Data Gathering Instrument for Trainee’s

Characteristics
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 Average grade in: Average grade in:

and numeracy English Math
(LL&N)
a. 95 and above a. 95 and above
b. 90 to 94 b. 90 to 94
c. 85 to 89 c. 85 to 89
d. 80 to 84 d. 80 to 84
a. 75 to 79 e. 75 to 79

language a. Waray
background b. Cebuano
c. Ilongo
d. Filipino
e. English
f. Others( please specify)_____________

Religion please specify:

Nationality please specify:

Education & Highest Educational Attainment:

general a. ALS
knowledge
b. High School Level
c. High School Graduate
d. College Level
e. College Graduate
Sex a. Male
b. Female
Age Your age: _____
Physical ability 1. Disabilities(if any)_____________________
 Characteristics of learners
2. Existing Health Conditions (Existing illness if
any)
a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
f. Diabetes
g. Others(please specify)
___________________

Previous List down ICT Related Certificates

experience with 1.
the topic 2.
3.

Previous List down trainings related to ICT

learning ___________none________________
experience ___________________________
___________________________
National Certificates acquired and NC level
Training Level
completed ___________none________________
___________________________

Learning styles 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
Date Developed: Document No. NTTA-TM1-07
December 2019 Issued by:
Date Revised:
Computer Page 2 of 3
Systems Servicing DBTC
NC II Developed by:
Edwin B. Rosco
Revision # 01
 Characteristics of learners

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.
d. Activist - Learns by having a go
e. Reflector - Learns most from activities where
they can watch, listen and then review what
has happened.
f. Theorist - Learns most when ideas are linked
to existing theories and concepts.
g. Pragmatist - Learns most from learning
activities that are directly relevant to their
situation.
Other needs a. Financially challenged
b. Working student
c. Solo parent
d. Others(please specify)
___________________________

Date Developed: Document No. NTTA-TM1-07

December 2019 Issued by:
Date Revised:
Computer Page 3 of 3
Systems Servicing DBTC
NC II Developed by:
Edwin B. Rosco
Revision # 01