QUESTIONNAIRE FORM

AIR POLLUTION AWARENESS CAMPAIGN

FOR RESIDENTIAL STUDENTS IN UTHM

Dear participants,

You are invited to participate in our research entitled Air Pollution Awareness
Campaign For Residential Students In UTHM.

For your information, this research is conducted for the purpose of completing my
assignment of English for Technical Purpose (UHB 30102).
Your participation in this research is completely voluntary. There are no right or
wrong answers to these questions. Your responses will be treated confidential and
anonymous. The results of the collected data are for research purposes and we hope to
enlighten some issues and could recommend appropriate solutions or strategies to
solve the issues.
This survey will take approximately 5 minutes of your time. I would like to thank for
your assistance in completing this survey.
Section A: Respondent Demographic Information.
Please tick (√) your answers in the box and write your answers in the space provided.

1. Gender:  male  female

2. Age :  18-20  21-25  26-30  31 and above

3. Race:  Malay  Indian  Chinese  Other: ______________

4. Residential College :

 KK Tun Syed Nasir

 KK Tun Dr. Ismail

 KK Tun Fatimah

5. Faculty:  FKEE

 FPTP

 FKAAS

 FSKTM

 FKMP

6. Do you really know about air pollution?

 I’m an expert about it

 Just general knowledge

 A little bit

 Not really

 Not at all

7. Do you think air pollution in UTHM is a serious problem?

 Very serious

 Serious

 Average

 Not really

 Not at all
8. Do you know what the biggest cause of air pollution in UTHM is?

 Yes, please state it:

_____________________________________________________________

 No

9. Do you agree if the factory near UTHM is the major contributor to this air pollution problem?

 Agree

 Maybe

 Disagree

 Don’t know

10. Do you agree if the factory near UTHM is closed?

 Absolutely

 Agree

 Depends on the situation

 Not really

 No need

 Disagree

Section B: Factor And Implication Of Air Pollution In UTHM

Please read the statement below carefully. Based on your opinion, select the
level of agreement by circling the number on a scale of 1 (Strongly Disagree) to
5 (Strongly Agree).

Degree of Strongly Strongly

Disagree Neutral Agree
Agreement Disagree Agree

Scale 1 2 3 4 5
 ITEMS

No. SCALE

Human activities like opens burning cause the

1. air pollution problem 1 2 3 4 5

Industrial emission causes the air pollution

2. problem 1 2 3 4 5

3. Increasing of moto vehicle emission causes 1 2 3 4 5

the air pollution problem

4. Air pollution has now become the largest 1 2 3 4 5

environmental health risk

5. Air pollution can cause serious health problem 1 2 3 4 5

Nothing can be done by me or my family /

friends to improve the current atmospheric
6 situation. 1 2 3 4 5

Air pollution threating the outdoors activities

7 In university 1 2 3 4 5

Thank you for your participation.