KK Profiling Form

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Respondent #: ____________

KK Survey Questionnaire
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 Birth: Male Age: ______________________ E-mail address: _____________________


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 Person w/ Disability


Married Annulled Youth Out of School Youth Children In Conflict w/ Law
Civil Status
Widowed Unkown Classification Working Youth
Divorced Live-in Youth w/ Specific Indigenous People
needs:
Child Youth (15-17 yrs old) Employed
Core Youth (18-24 yrs old) Unemployed
Youth age 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 Did you vote Yes
High school level Voter? No last SK No
High school Grad
Vocational Grad Registered Yes 1-2 Times
If Yes, How
Educational Background College Level National No 3-4 Times
many times?
College Grad 5 and above
Masters Level Have you Yes
Masters Grad already No There was no
Doctorate Level attended a KK If No, Why? KK Assembly
Doctorate Graduate Not Interested
to Attend
FB Account:_________________ Willing to join the group chat? Yes No

Thank you for your participation!


______________________________
Name and Signature of Participant

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