Good Day!

We, from Guisguis National High School, want you to participate on

our on-going survey about the different food choices of individuals from different ages
in our society. The purpose of this activity is for us to know which among the
generation eats the healthiest? We randomly select three students from elementary
and another three in High School. We will appreciate it,if you answer this with honesty
for 15 minutes. Please put a check beside the choices below. Your personal information
that we have, will be protected and will not be used in any publication as long as we
don’t have any permissions from you.

i. Respondent’s Name: (OPTIONAL) __________________________________

Grade Level: ______________________

Age: _______

Gender: _______________

Monthly Income of Parents: _________________

ii. Choose the answers that applies:

Which sort of the following foods you preferred to eat?

________ Pork ________ Vegetables

________ Chicken ________ Fruits
________ Beef

What type of fast food restaurants you always choose to go?

________ McDonalds ________ Starbucks
________ Jollibee ________ Shakey’s
________ KFC ________ Burger King

If you were to eat midnight snacks tonight, what will you bring?
________ Vcut Potato Chips ________ Popcorn
________ Piattos ________ Mix Nuts
________ Nauva
________ Pic- A Chips

Your mother let you pick some foodstuff for your fieldtrip, on all the choices,

what will you pick?

_______ Pringles Potato Chips _______ Apples, Grapes and Pears
_______ Egg Sandwich _______ Lays Chips
_______ Vegetable Salad

What is your preferred drinks in your meal or snacks?

_______ Soda _______ Tea
_______ Water _______ Milk
_______ Lemon Juice