You are on page 1of 1

DIRECTION: Supply the blank with the information needed.

Part I. PERSONAL PROFILE

NAME: __________________________________________________ AGE: _______________________

RELIGION: ________________________________________________ SEX:_______________________

EDUCATIONAL ATTAINMENT: __________________________ NATURE OF WORK:__________________

ADRESS:______________________________________________________________________________

DIRECTION: Put a check (/) mark on the boxes that corresponds to your satisfaction.

Part II. SATISFACTORY SURVEY

INDICATORS EXCELLENT GOOD FAIR


(3) (2) (1)
A. MANAGEMENT STYLE
1. Ability- his ability to govern and lead the country.
2. Consistency- consistent in every decision making.
3. Personality- attitude and values when it comes in dealing with
the people.
B.POLICIES
1. Smoking banned- if it is implemented and it is good for the
community.
2. War on Drugs- if it is helpful with the community.
3. Extra Judicial Killings- if it is implemented and in favour to the
people.
C.PROGRAMS AND PROJECTS
1. 4Ps- does the expected rate or the expectation of the people
meet?
2. Housing- does the house is conducive or appropriate and with
sanitation?
3. Free Tuition- if it is helpful and good for the people especially
with the teachers, parents and students.
D. SERVICES
1. Public Hospitals- does the nurse, doctor, security guard and
other employees are with good personalities and approachable?
2. Public Universities- does the faculty, cashiers, registrars and
other personnel are good with dealing and entertaining the clients?
3. Public Transportation- does the driver and conductor obey or
perform the fare discount policy?

___________________

Respondent’s signature

You might also like