DIAGNOSTIC SURVEY

SCHOOL DIAGNOSIS FOR DISASTER PREPAREDNESS (RESPONSE of the Students)

Name(optional)/Age_______________________
Address:_____________________________________ Grade 11 Grade 12 Irregular
Parents' Educational Attainment: Elementary High School College Level
_____________________________________________________________________________________

General Disaster Education:

1. Have you learned about the word hazards? Yes/No

If yes, where did you learn about hazards?

School ____

Home ____

Hospital ____

Others, please specify _____

2. Have you heard about the word disaster? Yes/No

If yes, where did you hear about the word disaster?

School____

Home ____

Hospital

Television, Radio ____

Others, specify

3. Do you think your school/place can be affected by disaster one day?

Yes/No

4. What type of disaster do you think can affect your school/place?

Floods ____

Landslides____

Earthquake ____

Tsunami

Volcanic Eruption

Others, please Specify___

None ____