Professional Documents
Culture Documents
Date:
In connection with this may we ask from your favorable office to allow us to
distribute questionnaire to fill up by the respondents.
Noted by:
Instruction: Please answer the following question with most sincere and honest
response.
Number of Children
( ) 1 – 2 Children
( ) 2 – 3 Children
( ) 3 – More Children
PART 2
I n s t r u c t i o n : Using the given scale below kindly check the numbers that
correspond to your best answer in every question.
2 – Less observed
1 – Not observed
Deforestation Rank
3 2 1
Urban Contraction
Illegal Logging
Agriculture
Commercial Purpose
Water Pollution Rank
3 2 1
Untreated Raw Sewage
Agricultural Wastewater
Human Waste
Soil Erosion Rank
3 2 1
Agriculture
Commercial Purpose
Quarrying
Climate changes Rank
3 2 1
Charcoal Making
Forest Fire by Indigenous
Illegal Logging
PART 3
I n s t r u c t i o n : Using the given scale below kindly check the numbers that
correspond to your best answer in every question.
4 – Very Active
3 – Active
2 – Less Active
1 – Not Active
Programs Rank
Skills Training Program
Education Support Program
Livelihood Program