LOCAL GOVERNMENT

REGION PROVINCE UNIT NAME

 KATIPUNAN KABATAAN DIRECTORIES
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uth
BIRTHDAY YOUTH wit
SEX
ASSIGN CIVIL CLASSIFICATION h
AGE ED AT STATUS ISY/OSY- Spe YOUTH AGE GROUP
Month Day Year BIRTH NEET/WY/YSN) cifi
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DIRECTORIES

EMAI
L CONTACT EDUCATION
ADD NUMBER HOME ADDRESS BACKGROUND WORK STATUS
RESS
Are you a Did you Have you
Are you a
registere vote last attended if yes, how
registered If No,
d SK National SK a KK many Why?
voter? voter? Y/N election? assembly times?
Y/N Y/N ?
KK Survey Questionnaire Respondent #: ____________
Date: ________________

TO THE RESPONDENT:
Good day!
We are currently conducting a study that focuses on assessing the demographic information of the Katipunan ng
Kabataan. We would like to ask your participation by taking your time to answer this questionnaire. Please read the
questions carefully and answer them accurately.

REST ASSURED THAT ALL INFORMATION GATHERED FROM THIS STUDY WILL BE TREATED WITH UTMOST
CONFIDENTIALITY.

I. PROFILE

Name of Respondent: ________________________________________________________________________

Last Name Middle Name Last Name Suffix

Location: __________________________________________________________________________________
Region Province City/Municipality Baranggay Purok/Zone

Sex Assigned Male Age: ______________________ E-mail address: _____________________

by Birth:
Female Birthday: __________________ Contact #: _________________________
(dd/mm/yy)

II. DEMOGRAPHIC CHARACTERISTICS

Please put a Check mark next to the word or Phrase that matches your response.

Single Separated In school Youth

Married Annulled Youth Out of School Youth Person w/ Disability
Civil Status Classification
Widowed Unkown Working Youth Children In Conflict
Divorced Live-in Youth w/ Specific needs: w/ Law
Indigenous People
Child Youth (15-17 yrs old) Employed
Youth age Core Youth (18-24 yrs old) Unemployed
Group Young Adult (15-30 yrs old) Work Status Self-Employed
Currently looking for a Job
Not Interested Looking for a Job
Elementary Level
Elementary Grad Registered SK Yes Yes
Voter? Did you vote last
High school level No SK election? No
High school Grad
Vocational Grad Registered Yes 1-2 Times
Educational National Voter? If Yes, How
Background College Level No many times? 3-4 Times
College Grad 5 and above
Masters Level Have you already
Yes
Masters Grad attended a KK No There was no
Assembly?
Doctorate Level If No, Why? KK Assembly Meeting
Doctorate Graduate Not Interested
to Attend

Thank you for your participation!

Name and Signature of Participant