Survey Questionnaire

(Student Respondents)

Direction: Read and analyze the following statements. Write your answer on the provided blanks.

1. What are the demographic profile of respondents in terms of:

Name (Optional): __________________________ Age:________ Gender:________

Civil Status: ( ) Single ( ) Married ( ) Separated ( ) Annualled ( ) Widowed

Address:___________________________________________________________

2. What are the reasons why there are motorcycle accidents in Barangay Mamatid Cabuyao City,

Laguna? (Circle the letter of your answer/s.)

A. Over speeding

B.

C.

3. What are the possible effects of motorcycle accidents in Barangay Mamatid Cabuyao City,

Laguna?_______________________________________________