APPENDIX A – Sample Questionnaire

STI College - Lucena

SENIOR HIGH SCHOOL PROGRAM
Lucena City, Quezon

Level of Effectiveness of Mosquito-Off Lemongrass Soap for The Senior High School
Students of Cotta National Highschool

I. DEMOGRAPHIC PROFILE
Name (Optional): Sex:
Age: Grade Level:
II. SURVEY QUESTIONS
Directions: Put a check on the columns along the row of the question ranging from the
scale below.
5 4 3 2 2
Statements Strongly Agree Neutral Disagree Strongly
Agree Disagree
Longevity
1. The soap features a long-
lasting effect on the skin.
2. The soap is easy discolored.
3. The scent of the soap stays
on the skin even after daily
activities.
4. The soap retains its shape
even after use.
5. The soap is quick to spoil.
Cost-Efficiency
1. The cost of the soap is
reasonable.
2. The soap is affordable.
3. The cost of the soap
encourages me to buy it.
4. The effectiveness of the
soap encourages me to buy
it considering its cost.
5. The soap lasts long
considering its price.

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Usefulness
1. The soap successfully
repels mosquitoes.
2. The soap does not produce
foul odors that would
prevent me from using it.
3. The soap is discomforting.
4. The soap does not irritate or
damage my skin.
5. The soap cleanses my skin.

____________________________
Signature

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