VALIDATION FORM FOR SURVEY INSTRUMENT

Using the criteria developed for evaluating survey questionnaires set forth by Cater V.
Good & Douglas B. Scates, please evaluate the attached self-made survey instrument for the
study. Rating: 1 – Poor & 5 – Excellent

Kindly check the respective boxes provided herein.

Criteria for Validity 1 2 3 4 5

1. The questionnaire is short enough to respond;
it would not drain much of his precious time.
2. The questionnaire is interesting and has a face
appeal such that respondents will be induced
to respond to it and accomplished it fully.
3. The questionnaire can obtain some depth to
the responses and avoid superficial answer.
4. The items/questions and their alternative
responses are not too aggressive nor too
unstimulating.
5. The questionnaire can elicit responses which
are define but not technically forced.
6. Questions/items are stated in which way that
the responses will not be embarrassing to
person/persons concerned.
7. Questions/items are formed in such manner to
avoid suspicion on the part of the respondents
in the questionnaire.
8. The questionnaire is not too much narrow nor
restricted or limited in its philosophy.
9. The responses in the questionnaire when
taken as a whole, could answer the basic
purpose for which the questionnaire is design
and therefore considered valid.

Interpretation Guide:

Excellent 4.21 – 5.00

Very Good 3.41 – 4.20
Good 2.61 – 3.40
Fair 1.81 – 2.60
Poor 1.00 – 1.80

Thank you.

Signature Over Printed Name of Validator

Date: _____________________________