KK SURVEY QUESTIONAIRE

KATIPUNAN NG KABATAAN PROFILING

To gather the information and data of the Katipunan ng Kabataan members, the
Sangguniang Kabataan of Barangay Basak will be conducting a youth profiling to establish,
maintain, and update the database of the youth in the Barangay Basak. The data to be
obtained will be submitted to the Commission while ensuring proper turnover to the
succeeding set of SK officials in compliance with the Data Privacy Act of 2012 (R.A. No.
10173).

Section 5 (b) of the Implementing Rules and Regulations (IRR) of RA No. 10742 stipulates
that the Katipunan ng Kabataan (KK) serves as the highest policy-making body deciding on
matters affecting the youth in the barangay. Section 4 of the same law defines "KK" as
citizens of the Philippines residing in the barangay for at least six (6) months, aged fifteen
(15) to thirty (30) years, duly registered in the Commission on Elections (COMELEC) voters'
list and/or based on the list of KK members custody. er the SK secretary's

The primary objective of this youth profiling is to systematically identify and gather essential
information about all youth aged fifteen (15) to thirty (30) years old within our Barangay.
These gathered details will serve as the foundational basis for formulating pertinent
programs and policies.

* Indicates required question

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1. LAST NAME *

2. FIRST NAME *
3. MIDDLE NAME *

4. GENDER *

Mark only one oval.

Male

Female

5. BIRTHDAY *

Example: January 7, 2019

6. AGE *

7. PUROK *

Check all that apply.

Purok Lipayhan
Purok Kalamunggay
Purok Mangga
Purok Imelda
Purok Nagtuhob
Purok Lina

8. E-MAIL ADDRESS
9. CONTACT NUMBER

10. CIVIL STATUS *

Check all that apply.

Single
Married
Widowed
Divorced
Separated
Unknown
Annulled
Live-in

11. YOUTH AGE GROUP *

Check all that apply.

Child Youth (12-15 yrs old)

Child Youth (15-17 yrs old)
Core Youth (18-24 yrs old)
Young Adult (25-30 yrs old)
12. EDUCATIONAL BACKGROUND *

Check all that apply.

Elementary Level
Elementary Grad.
Highschool Level
Highschool Grad.
Vocational Grad.
College Level
College Grad.
Master Level
Master Grad.

13. YOUTH CLASSIFICATION *

Check all that apply.

In School Youth
Out of School Youth
Working Youth

14. WORKING STATUS *

Check all that apply.

Employed
Unemployed
Self-employed

15. REGISTERED SK VOTER? *

Check all that apply.

YES
NO
16. REGISTERED NATIONAL VOTER? *

Check all that apply.

YES
NO

17. HAVE YOU ATTENDED A KK ASSEMBLY? *

Check all that apply.

YES
NO

18. WITH YOUTH ID? *

Check all that apply.

YES
NO

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