MR #: _____

Consent Form
Participate in Research-Study Pre-Test Questionnaire

___NAME_______, student of “M.phil” at Khadim Ali Shah Bukhari Institute of technology (A

Member of KASB Group); is working on his Final Project of Research on “TOPIC "
You are advised to cooperate with him for collection of data. Your kind cooperation will be
highly appreciated. If you agree to be part of the research study, you are requested to fill a
questionnaire. The first part is about demographic information and second part consists of
questions about research variables.

Your information will remain confidential and will not be shared with others, except the use for
the analysis and findings in the research study.

Demographic Information

1. Gender 2. Age Group 3. Household Income level

 Male  Below 20 years  Below 25000
 Female  21 to 30 years  5,000 - 10,000
 31 to 40 years  11,000 - 20,000
 41 to 50 years  21,000 – 30,000
 51 and Above  Other, ___________

4. Qualification 5. Work Experience

 Metric  Less than 1 year
 Intermediate  1-3 years
 Bachelors  4-6 years
 Masters  7-10 years
 Diploma certificate  Above 10 years
 Other, ___________

Respondent’s Email or Contact:

 MR #: _____

Instruction: Tick anyone option of the following: Strongly Agree Neutral Disagree Strongly
Agree Disagree
VARIABLE NAME (Yawar, 1980; Dilawar 2007)
1
2
3
4
5
VARIABLE NAME (Khawar, 1987)
6
7
8
VARIABLE NAME (Munawar, 1993)
9
10
11
VARIABLE NAME
12
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15
VARIABLE NAME
16
17
18

Any Comments?

Thank you for your response.