Data Gathering Instrument for Trainee’s Characteristics

Please answer the following instrument according to the

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

Characteristics of Learners
Language, literacy Average grade in: Average grade in:
and numeracy (LL&N) English Math
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 background a. Tagalog
b. Cebuano
c. Visayan
d. Ilonggo
e. Muslim
f. Ilocano
g. Hiligaynon
h. Waray
i. Others (please specify)_______________
Educational & Highest Educational Attainment:
general knowledge a. Junior High School Graduate
b. Senior High School Graduate
c. Senior High School Level
d. ALS Graduate
e. Trade School Graduate
f. College Level
g. College Graduate
h. Others (please specify) _______________
Sex a. Male
b. Female
Age
Your age: ______________
Physical ability 1. Disabilities (if any) _________________________
2. Existing Health Conditions
a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
f. Diabetes
g. Others (please specify) ___________________
Previous learning List down training related to Electrical
experience Installation and Maintenance NC II
a. First Aid
b. Earthquake Drill
c. Fire Drill
d. Others: _____________
National Certificate acquired and NC level
Training Level a. SMAW NC I
completed b. Carpentry NC I
c. Masonry NC I
d. Others: ______________
Other courses related to Electrical Installation
and Maintenance NC II
a. BS in Electrical Engineering
Special courses
b. BS in Secondary Education major in TLE
c. BS in Information Technology
d. Others: _____________

a. Visual – The visual learner takes mental

pictures of information give, so in order for
this kind of learner to retain information,
oral or written, presentations of new
information must contains diagrams and
drawings, preferably in color. The visual
learner can’t concentrate with a lot of
activity around him and will focus better
and learn faster in a quiet study
environment.
b. Kinesthetic – described as the students in
the classroom, who have problems sitting
still and who often bounce their legs while
tapping their fingers on the desks. They
are often referred to as hyperactive
Learning Style
students with concentration issues.
c. Auditory – a learner who has the ability to
remember speeches and lectures in detail
but has a hard time with written text.
Having to read long texts is pointless and
will not be retained by the auditory learner
unless it is read aloud.
d. Activist – Learns by having a go
e. Reflector – Learns most from activities
where they can watch listen and then
review what has happened.
f. Theorist – Learns most when ideas are
linked to existing theories and concepts.
g. Pragmatist – Learns most from learning
activities that are directly relevant to their
situation.
 a. Excellent
b. Very Good
c. Good
Computer Literacy
d. Fair
e. Needs Assistance

a. Financially Challenge
b. Working Student
Other Needs c. Solo Parent
d. Others (please specify)__________________

Name: Date: