KK Survey Questionnaire Respondent #: ____________

Date: ________________

TO THE RESPONDENT:
Good day!
We are currently conducting a study that focuses on assessing the demographic information of the Katipunan ng Kabataan.
We would like to ask your participation by taking your time to answer this questionnaire. Please read the questions carefully
and answer them accurately.

REST ASSURED THAT ALL INFORMATION GATHERED FROM THIS STUDY WILL BE TREATED WITH UTMOST
CONFIDENTIALITY.

I. PROFILE

Name of Respondent: ___________________________________________________________________________

Last Name First Name MIddle Name Suffix

Location: ______________________________________________________________________________________
Region Province City/Municipality Baranggay Purok/Zone

Sex Assigned by Male Age: ______________________ E-mail address: _____________________

Birth:
Female Birthday: __________________ Contact #: _________________________
(dd/mm/yy)

II. DEMOGRAPHIC CHARACTERISTICS

Please put a Check mark next to the word or Phrase that matches your response.

Single Separated In school Youth

Married Annulled Youth Out of School Youth Person w/ Disability
Civil Status Classification
Widowed Unkown Working Youth Children In Conflict
Divorced Live-in Youth w/ Specific needs: w/ Law
Indigenous People
Child Youth (15-17 yrs old) Employed
Youth age Core Youth (18-24 yrs old) Unemployed
Group Young Adult (15-30 yrs old) Work Status Self-Employed
Currently looking for a Job
Not Interested Looking for a Job
Elementary Level
Elementary Grad Registered SK Yes Yes
Voter? Did you vote last
High school level No SK election? No
High school Grad
Vocational Grad Registered Yes 1-2 Times
Educational National Voter? If Yes, How
Background College Level No many times? 3-4 Times
College Grad 5 and above
Masters Level Have you already
Yes
Masters Grad attended a KK No There was no
Assembly?
Doctorate Level If No, Why? KK Assembly Meeting
Doctorate Graduate Not Interested
to Attend

Thank you for your participation!

Name and Signature of Participant

 LOCAL GOVERNMENT
REGION PROVINCE
UNIT
 BIRTHDAY
SEX
NAME AGE ASSIGNED
Month Day Year AT BIRTH
 KATIPUNAN KA

YOUTH
CIVIL CLASSIFICATION If Youth with YOUTH AGE
STATUS ISY/OSY-NEET/WY/ Specific Needs GROUP
YSN)
KATIPUNAN KABATAAN DIRECTORIES

EMAIL ADDRESS CONTACT NUMBER HOME ADDRESS

S

Are you a registered SK voter?

EDUCATION BACKGROUND WORK STATUS Y/N
Are you a registered National Did you vote last SK election? Have you attended a
voter? Y/N Y/N KK assembly?
if yes, how many times? If No, Why?

NONE
Male
Female
February
March
April
Single
Married
Widowed
Common- in-law/ live in
Divorced
Separated
Annulled
Unknown
###
Elementary Level