Appendix

QUESTIONNAIRE CHECKLIST OF FOR MONITORING AND EVALUATION OF ALTERNATIVE

LEARNING SYSTEM IN DIVISION OF QUEZON CITY – DISTRICT 4

I. PROFILE OF RESPONDENTS
Directions: Please put a slash (/) mark on the appropriate box and fill in the needed
information the best describe your personal background.

Name (Optional)

Name of School / Community

Learning Center

School / CLC Address

PERSONAL BACKGROUND

Age : Civil Status : Single Widower

Sex : Male Female Married Separated

EDUCATIONAL BACKGROUND

High School Level Gr. 7 ____ Gr 8 ______ Gr 9_______ Gr 10_______

Elem Level Gr 1 ____ Gr 2 _____ Gr 3 ____ Gr 4 ____ Gr 5 ____ Gr 6 _____

No Basic Literacy

EMPLOYMENT BACKGROUND:

Working Non - Working

If working, kindly fill up the information:

Nature of Years Employed Nature of Work

Check the reasons why you have enrolled in Alternative Learning System Program:

Financial problem Family Problem Others Pls. specify the reason

What are the difficulties / problems that you have encountered in Alternative Learning System
Program?
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