It may help during your thesis (Questionnaires may vary, according to what is your topic). This Questionnaire is for problems and aspirations of college students.

1. I. Profile ofthestudent
Directions: Put a check mark in the box provided in each item which corresponds to your answer. For
others, please write what is needed.
Name:_______________________________________________________________________
Year level:_______________________________
Age: ______________ Place of Residence: __________________________________________
Monthly Income
 3,000 – 5,000
 5,000 – 10, 000
 10,000 – 15,000
 15,000 – Above
Family
No. of Siblings:
 1
 2
 3
 4
 5
 6 and above
No. of Professional Siblings:
 1
 2
 3
 4
 5 and above
Mother’s Name: ___________________________________________ Occupation: _________________
Educational Attainment:
 Elementary Undergraduate
 Elementary Graduate
 High School Undergraduate
 High School Graduate
 College Undergraduate
 College Graduate

2. Father’s Name: ____________________________________________ Occupation: _________________
Educational Attainment:
 Elementary Undergraduate
 Elementary Graduate
 High School Undergraduate
 High School Graduate
 College Undergraduate
 College Graduate
II. Aspirations of the Students
Directions: Put a check mark in the box provided for each item to indicate your answer.
4- Very much aspire
3- Fairly aspire
2- Slightly aspire
1- Not aspire at all
Personal Aspirations 4 3 2 1
1. To eat delicious foods or meals
2. To be able to have enough supply of personal hygiene
materials ( face powder, comb, cologne)
3. To beable to follow trendsin terms of gadgetsand clothes.
4. To have sufficient allowance
5. To have enough school materials
Family and Relationship Aspirations 4 3 2 1
1. To have a financially stable family
2. To have the health of the family secured
3. To have a pleasant home
4. And To feel love and support by the whole family
5. To have many friend
6. To have a good relationship with others including my
teachers
AcademicAspirations 4 3 2 1
1. To meet deadlines for academic requirements
2. To earn high grades
3. To pass all the subjects needed for the course
4. To maintain my scholarship privilege
5. To be able to graduate on time
6. To get prepared for the licensure examination