Republic of the Philippines

CAVITE STATE UNIVERSITY

Trece Martires City Campus

____________
________

Date

Dear Participants ,

We, the students of Cavite State University-Trece Martires City Campus, are
currently conducting a study regarding "Community Needs Assessment for the
Extension Program of Cavite State University-Trece Martires Campus". This
study covers the Rural Improvement Club of seven barangays in Trece Martires City.
The main objective of this study is to determine the needs of the community for the
extension program of Cavite State University's Trece Martires City Campus.

You are one of the selected participants in this study. Please answer this
questionnaire carefully. The results of this questionnaire are required for the study,
so your response is greatly appreciated. Of course, we won't use it for anything that
could be harmful. Thank you very much!

Sincerly,

Marlon Serrado Deceryl Gandalla Jasmine Frago John Harvey Alano

Juliet Mercado John Carlo Lugay Miguel Brayn Rentorio Pamela Tongol

SURVEY QUESTIONNAIRE

Direction: In the following, put a check mark (/) where your answer corresponds.

I.SOCIO-DEMOGRAPHIC PROFILE

Name (Optional): __________________ Male: ___ Female:___

Prefer not to say:___

Age:

___15-20 ___34-38 ___49-53

___21-28 ___39-43 ___54-59

___29-33 ___44-48 ___60- Above

Civil Status: ___Single ___Married ___Widow ___Other

Barangay:

___ Aguado ___ Gregorio ___ Lallana

___ Inocencio ___ Osorio

___ Cabuco ___ San Agustin

Years of staying in the Barangay:____

Housing Status:

___ Rent ___ Own

Educational Attainment:

___ Elementary Level ___ Senior High School Level

___ Elementary Graduate ___ Senior High School Graduate

___ Junior High School Level ___ College Level

___ Junior High School Graduate ___ College Graduate

Employment Status:

___ Regular ___ Casual ___ Seasonal

___ Project ___ Fixed Term ___ Probationary

Sectors:

___ Farmers ___ Self- employed and Unpaid Family Workers

___ Fisherfolks ___ Individuals Residing in Rural Areas

___ Persons with Disability ___ Out of school youth

___ Youth ___ Out of Youth

___ Senior Citizens ___ Women

Monthly Income:

___ Below -10,957 ___43,828-76,669

___10,957 - 21,914 ___76,669-131,484

___21,914 - 43,828

II. NEEDS ASSESSMENT

Direction: In the following, please check (/) at which point you need more
information. (You can choose more than one of each aspect)

1.Community empowerment and capacity building

___ Training for Computer Literacy

___ Help in Youth Enrichment

____ Training to enhance communication skills

___ Mental Health Program

___ Educational Assistance

___ Sports Participation

___ Financial Literacy Training

___ Medical mission

___ Leadership Training

___ Apprenticeship and Internship Programs

2. Community entrepreneurship

___ Providing a capital for small starter business or livelihood project

___ Training on starting a business or livelihood

___ Webinar about Facebook Reels Income

___ Seminar about Marketing Branding and Strategies

___ Creating a program support for small business

___ Training for TikTok Affiliation

___ Lazada, TikTok and Shopee selling Training

___ Food Processing

___ Meat Processing

___ Youth Entrepreneurship Programs

3. Community employment

___ Conducting an Online Job Training

___ Skill Mapping/ Job fair

___ Career Development program

___ Job Training

___ TESDA Training

___ Knowledge about the process of applying for a job local

___ Knowledge about the process of applying for a overseas Filipino worker

___ Training for Manufacturing job

___ Training about Customer Service or Call Centers

___ Training for Job Interview

4. Community social support and community engagement

___ Counseling and Therapy Services

___ Creating cooperative or union

___ Having some recreational activities

___ Knowledge on Family Planning

___ Training on Basic First Aid

___ Program on Clean Up drive

___ Inputs on waste management

___ Training the out of school youth

___ Education about early pregnancy

THANK YOU!