Name:Rozilawathy Ayop ID:2010821798

A. Demographic question
Please circle your answer

ID

Subject 1. Gender

Question What is your sex?

Answer o Male o Female

2. Age

How old are you?

o 20-25 years old o 26-30 years old o 31 to 35 years old o 36 to 40 years old o 4 1 and above

3. Marital Status

What is your marital status?

O Married o Widowed o Divorced o Separated o Never married

4.Education

What is the highest degree or level of school you have completed? If currently enrolled, mark the previous grade or highest degree received.

o High school graduate SPM o Certificate o Diploma o Degree o Master o PHD

5. House living

How long have you been living there?

o Less tha3n 9 years o 10-19 years o 20-29 o 30-39 o More than 40 years

6.Children

How many children you have?

o 0 o 1-2 o 3-4 o 5-6

Name:Rozilawathy Ayop ID:2010821798 o 7-8 O 9-10

7. Housing

Is this house, apartment, or mobile home -

o Owned by you or someone in this household with a mortgage or loan? o Owned by you or someone in this household free and clear (without a mortgage or loan)? o Rented o Occupied without payment of cash rent?

8.Household Income

What is your total household income per anum?

o RM10,00 to RM13,000 o RM14,000 to RM17,000 o RM18,000 to RM21,000 o RM22,000 to RM23,000 o RM24,000 to RM27,000 o RM28,000 to Rm31,000 o RM 32,000 and above

9.Race

Please specify your race

O Malay o Chinese o India o Others

10.Religion

Please specify your religion

O Muslim o Buddha o Hindu o Christian o Jewish o Others

Name:Rozilawathy Ayop ID:2010821798

Name:Rozilawathy Ayop ID:2010821798