DATA GATHERING INSTRUMENT FOR TRAINEE’S CHARACTERISTICS

LILIBETH M. BANTE DOMESTIC WORK NC II

Please answer the following instrument according to the characteristics

described below. Encircle the letter of your choice that best describes you as a
learner. Blank spaces are provided for some data that need your response.

CHARACTERISTICS OF LEARNERS

Language, literacy Average grade in: Average grade in:

and numeracy English Math
(LL&N) a. 95 and above a. 95 and above
b. 90 to 94 b. 90 to 94
c. 85 to 89 c. 85 to 89
d. 80 to 84 d. 80 to 84
e. 75 to 79 e. 75 to 79
Cultural and Ethnicity/culture:
language backgrounda. Ifugao
b. Igorot
c. Ibanag
d. Gaddang
e. Muslim
f. Ibaloy
g. Others( please specify) Bicolano
Education & general Highest Educational Attainment:
knowledge a. High School Level
b. High School Graduate
c. College Level
d. College Graduate
e. with units in Master’s degree
f. Masteral Graduate
g. With units in Doctoral Level
h. Doctoral Graduate
Sex a.
b. Male
c. Female
Age
Your age: 48

Physical ability a. Disabilities(if any) ____none √

b. Existing Health Conditions (Existing illness if any)
 None
 Asthma
 Heart disease
 Anemia
 Hypertension
 CHARACTERISTICS OF LEARNERS

 Diabetes
Others(please specify) ___________

Previous Work Work Duration

experience related to a. none
the qualification b. 1 month-6 months
c. 6 months-1 year
d. 1 year-more
Previous learning List down trainings/seminar related to Food and
experience Beverage Services
1. Bread and Pastry Production
2.

Learning style Please refer to the previous learning style assessment

a. Kinesthetic
Auditory
Visual
b.
Other needs a. Financially challenged
b. Working student
c. Solo parent
d. Others(please specify) __________________