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Republic of the Philippines

Technological University of the Philippines


College of Architecture and Fine Arts

BARANGAY/COMMUNITY TRAINING NEEDS/ ASSESSSMENT

CLIENT’S NAME: ____________________________________________________________

AUTHORIZE REPRESENTATIVE: ______________________________________________

ADRESS: __________________________________________________________________

CONTACT NOS._________________ EMAIL ADD/FB ACCT. ____________________

NATURE OF CLIENT:
PLEASE CHECK
 BARANGAY/COMMUNITY
 COMPANY
 INSTITUTION/SCHOOL
 FOUNDATION
 CHRUCH/CHAPEL
 OTHERS, PLS SPECIFY
___________________

NATURE OF EXTENSION SERVICE:


PLEASE CHECK
 Technology Transfer
 Others, pls specify
 ______________________

Section 1. Community Outreach and Community Service


 Community Outreach
Collaboration with external groups in mutually beneficial partnerships that are grounded in
scholarship and consistent with [the] role and mission of their professional appointment
 Community Service
Co-curricular or extra-curricular service that is done apart from or in addition to academic or
professional duties.
SURVEY QUESTIONS
Answer the following questions.

1. Do you need tables and chairs?


 Yes
 No

2. How many tables and chairs are needed?

No. of Chairs ______

No. of Tables ______

3. Where will you use the table and the chair?


____________________________________________________________________________
____________________________________________________________________________

4. What type of finish do you like to the product?

A. Varnish
 Mahogany
 Maple

B. Painted
 Semi-Gloss
 Matte
 Enamel

Please indicate the finishing color of the product___________

Disclaimer:
This survey is for general analytical purposes only. Your individual responses will not be given to any third party
whatsoever. We are not guarantee that the product will be directly donated to your specific nature. Since we are still
conducting a survey and our panelist will decide for the donated product.

______________________________
Signature over printed Name
Authorize Representative

Assessed by:
_______________________

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