The structured questionnaire below was prepared as a data gathering tool to help the trainer

collect data on trainee’s characteristics. This questionnaire maybe filled up by each trainee and
validated by the trainer from possible sources like the Trainee’s Profile and through personal
interview of each trainee.

NOTE: PLS. ASK YOUR PARTNER TO ANSWER THE FOLLOWING TO BE INCLUDED IN

YOUR TM1 PORTFOLIO.

NAME OF TRAINEE: WINNIE JANE D. IGOT

Sample Data Gathering Instrument for Trainee’s Characteristics

Please answer the following instrument according to the characteristics described below.
Encircle the letter of your choice that best describes you as a learner. Blank spaces are provided for
some data that need your response.

Characteristics of learners

Language, literacy Average grade in: Average grade in:

and numeracy English Math
(LL&N) a. 95 and above a. 95 and above
b. 90 to 94 b. 90 to 94
c. 85 to 89 c. 85 to 89
d. 80 to 84 d. 80 to 84
e. 75 to 79 e. 75 to 79

Cultural and Ethnicity and culture:

language a. Ifugao
background b. Igorot
c. Ibanag
d. Muslim
e. Ibaloy
f. Others (please specify) TAGALOG

Educational & Highest Educational attainment:

general knowledge a. High School Level
b. High School Graduate
c. College Level
d. College Graduate
e. With units in Master’s Degree
f. Masteral Graduate
g. With units in Doctoral level
h. Doctoral Graduate
a. Male
Sex b. Female

Age Your age: ____20___

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 Characteristics of Learners

Physical Ability 1. Disability (if any) _____NA_______

2. Existing Health Conditions (Existing illness if any)

a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
f. Diabetes
g. Others (please specify) _________________

Previous TM Certificates
experience with a. TQ certified
the topic b. TM graduate
c. TM trainer
d. TM lead trainer
Number of years as a competency trainer ____N/A__________
List down trainings related to TM
Previous learning ___________________N/A__________________
experience _________________________________________
_________________________________________

National Certificates acquired and NC level

Training Level
completed EVENTS MANAGEMENT SERVICE NC II

______________________________________

Other courses related to TM

Special courses a. Units in Education
b. Master’s degree units in education
c. Others (please specify) N/A

Learning styles
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a. Visual – The visual learner takes mental pictures of information
given, so in order for this kind of learner to retain information, oral
or written, presentations of new information must contain diagrams
and drawings, preferably in color. The visual learner can’t
concentrate with a lot of activity around him and will focus better
and learn faster in a quiet study environment.
b. Kinesthetic – describes as the students in the classroom, who have
problem sitting still and who often bounce their legs while tapping
their fingers on the desks. They are often referred to as hyperactive
students with concentration issues.
c. Auditory – a learner who has the ability to remember speeches and
lectures in detail but has a hard time with written text. Having to
read long texts is pointless and will not be retained by the auditory
learner unless it is read aloud.
 d. Activist – learns by having a go.
e. Reflector – learns more from activities which they can watch,
listen and then review what happened.
f. Theorist – learns most when ideas are linked to existing theories
and concepts.
g. Pragmatist – learns most from learning activities that are directly
relevant to their situation

Other needs a. Financially challenged

b. Working student
c. Solo parent
d. Others (please specify) ______________________

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