NUTRIME: A WEBSITE FOR HEALTH AND NUTRITION LEARNING

Questionnaire

Dear Respondent,

In connection with the research capstone entitled “NUTRIME: A Website for Health and
Nutrition Learning” of Grade 12-STEM II students, may we request you to provide voluntary
response for the data called for an answer the questions truthfully.

Please return the accomplished survey-questionnaire not later than March 6, 2019.

Thank you.
Yours Truly,

Jill Mae Marie R. Base

Anna Sophia V. Vigo
Deanna Marie Blaise C. Galido
Clea Marie R. Flaviano
Nathaniel Josh J. Sodusta
Researchers

PART I. SOCIO DEMOGRAPHIC PROFILE

Directions: Kindly provide your personal data by supplying the information asked, by
checking the appropriate box.

Name:

(Last Name) (First Name) (M.I.)

Home Address:

Age:
Sex: ( ) Male ( ) Female
Religion: Contact Number:

Participant: ( ) Parents ( ) Healthcare Professional ( ) Community

Profession:

Email Address: