Researchers Survey Questionnaire

Brief description what is your study all about.

PART I- Socio-Demographic Profile

Instructions: Please answer the questions honestly. Rest assured

that your answer will be treated with outmost confidentiality.
Thank you. (instruction how they are going to answer the
questions)

NAME: __________________________
(Optional)

AGE:
( ) 20-39
( ) 40-55
( ) 55 and above

SEX: ( ) Male ( ) Female

CIVIL STATUS:
( ) Single
( ) Married
( ) Widow/er
( ) Separated

EDUCATIONAL ATTAINMENT:
( ) Masters Level
( ) Masters Graduate
( ) Doctoral Level
( ) Doctoral Graduate

PART II. (state what is this part all about)

Instructions: Please answer the questions honestly. Rest assured

that your answer will be treated with outmost confidentiality.
Thank you. (Instruction how they are going to answer the
questions)
5 – Strongly Agree (SA)
4 – Agree (A)
3 – Partially Agree (PA)
2 – Disagree (D)
1 – Strongly Disagree (SD)

SA A PA D SD
Indicators