Sample 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
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
a. 75 to 79 e. 75 to 79

Cultural and Ethnicity/Culture:

language a. Ifugao
background
b. Igorot
c. Ibanag
d. Gaddang
e. Muslim
f. Agta
g. Others (please specify) _____________________

Religion a. Roman Catholic

b. Born Again Cristian
c. Islam
d. Others (please specify) _____________________

Education & Highest Educational Attainment:

general a. High School Level
knowledge
b. High School Graduate
c. College Level

Date Developed: Document No. 00

Issued by:
San Francisco October 24,
Institute of 2022
Developed by:
SFIST
science and Page 1 of 4
Technology BUAL, IRENE
H. Revision # 01
 Characteristics of learners
d. College Graduate
e. with units in Master’s degree
f. Masteral Graduate
g. With units in Doctoral Level
h. Doctoral Graduate
Sex a. Male
b. Female
Age Your age: 37 yrs./old
Physical ability 1. Disabilities (if any) NONE
2. Existing Health Conditions (Existing illness if
any)
a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
f. Diabetes
g. Others (please specify) _____________________

Previous Technical Certificates:

experience with
the topic NONE

Previous List down trainings related to NC Level:

learning
experience NONE

National Certificates acquired and NC Level:

Training Level
completed
NONE

Date Developed: Document No. 00

Issued by:
San Francisco October 24,
Institute of 2022
Developed by:
SFIST
science and Page 2 of 4
Technology BUAL, IRENE
H. Revision # 01
 Characteristics of learners

Special courses Other courses related to Technical

Education:
a. Vocational Course
b. Industry/Company Training
c. Units in education
d. Master’s degree units in education
e. Others (please specify) NONE

Learning styles a. Visual - The visual learner takes mental

pictures of information given, so in order for
this kind of learner to retain information, oral
or written, presentations of new information
must contain 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 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.

Date Developed: Document No. 00

Issued by:
San Francisco October 24,
Institute of 2022
Developed by:
SFIST
science and Page 3 of 4
Technology BUAL, IRENE
H. Revision # 01
 Characteristics of learners

g. Pragmatist - Learns most from learning

activities that are directly relevant to their
situation.
Other needs a. Financially challenged
b. Working student
c. Solo parent
d. Others(please specify)
___________________________

Date Developed: Document No. 00

Issued by:
San Francisco October 24,
Institute of 2022
Developed by:
SFIST
science and Page 4 of 4
Technology BUAL, IRENE
H. Revision # 01