PRE - SURVEY FORM

NAME: _______________________________ DATE: ____________________

YEAR/COURSE: _________________________
(Please Fill Up the Above Info)

INSTRUCTION: Please mark a check (/) in the corresponding box of your answer. Refer to the
list below for your corresponding answer.
Numerical Rating Equivalent Rating
5 Strongly Agree
4 Agree
3 Fairly Agree
2 Disagree
1 Strongly Disagree

NUMERICAL RATING 5 4 3 2 1
SITUATION
1. Brownout or Power blackout is
inconvenient.
2. It is more convenient to study in classrooms
especially when having presentations if
there is a back- up power supply when
power interruption occur.
3. Class discussion will be dismissed because of
power interruption.

4. Does “Urea Electrolysis” can be used as an

alternative power source?

5. “Urea Electrolysis” will reduce the actual

gasoline consumption of the generator.

6. Is “Urea Electrolysis” cost free and safe to

the environment?
 EVALUATION FORM

NAME: _______________________________ DATE: ____________________

YEAR/COURSE: _________________________

(Please Fill Up the Above Info)

We, the 5th year BSEE students, are conducting our project study entitled “Urea Electrolysis
Powered Generator”, with this, we would like to ask certain questions that will help us in
evaluating different important factors regarding our study.

INSTRUCTION: Please mark a check (/) in the corresponding box of your answer. Refer to the
list below for your corresponding answer.

Numerical Rating Equivalent Rating

5 Strongly Agree
4 Agree
3 Fairly Agree
2 Disagree
1 Strongly Disagree

NUMERICAL RATING 5 4 3 2 1
SITUATION
A. Functionality
1. The prototype is can be an alternative source
of energy

2. The prototype is working as designed.

3. The prototype is an innovation electric

generation concept

4. The prototypes function is easy to

understand

5. The prototype is environment friendly.

 B. Effectiveness
1. Urea electrolysis produces enough hydrogen
to sustain the generator’s function.

2. The prototype design is easy to operate or

user friendly.

3. The prototype may still be enhanced and

modified for improvement.

4. The prototype has less waste and fewer

emission than gasoline.

5. The prototype is safe to use.

C. Efficiency
6. The output power of the prototype is enough
to sustain its functions and loads.

7. The output current and voltage is usable.

8. The output power is close to the input

power.