SURVEY QUESTIONNAIRE

I. PROFILE
Name: (Optional) ______________________________________________
Age: 12-13 14-15 16-17
Grade level: Grade 7 Grade 8 Grade 9 Grade 10
Grades:
Economic status:
How do you consider yourself? What are the main income
sources of your family?
1 ( ) Very poor
( ) Farming
2 ( ) Poor
( ) Wood and wood products
3 ( ) Lower middle income
level ( ) Trading
4 ( ) Middle income level ( ) Tourism
5 ( ) Higher middle income ( ) Rental income
level
( ) Pensions
6 ( ) Rich
( ) Poverty funds
7 ( ) Very rich
( ) Government Officials
( ) Other (please specify)
_______________
What is the average monthly income of the household?
5,000-15,000
16,000-30,000
31,000-45,000
Other (please specify) ___________

Number of years as a GSP member:

PART II. Benefits of Girl Scouting
Direction: Kindly check the appropriate box of your choice. Refer
to the rating scale.
4 –Strongly Agree 2 –Disagree
3 –Agree 1 –Strongly Disagree
A. Leadership skills 4 3 2 1
Make you a more responsible member of your
community.
Make you feel empowered
I am competent and capable in the activities
that are important to me.
My social relationships are supportive and
rewarding. When I see a problem, I prefer to do
something about it rather than sit by and let it
continue.
Provide you with leadership opportunities that
you didn’t get elsewhere.

B. Decision making skills 4 3 2 1

Being a Guide/Scout gives me better skills for
taking decisions about my life.
I am optimistic about my future.
Open your eyes to possibilities for your future
Make decisions without others’ input
Make decisions and stick by them
Given me the opportunity to practice ethical
decision-making

C. Socialization 4 3 2 1
Being a scout helps me handle peer pressure.
Being a Guide/Scout helps me with my
relationships with Adults.
I actively contribute to the happiness and well-
being of others.
I communicate my points clearly to others
I listen to other people’s opinions
I can confidently speak about issues to other
people
Others would say I am a good listener

PART III. Assessment of the Benefits of GSP Members

A. DECISION-MAKING ALWAYS OFTEN SOMETIMES RARELY NEVER
SKILLS
Being a Guide/Scout
gives me better skills
for taking decisions
about my life.
I am optimistic about
my future.
Open your eyes to
possibilities for your
future
Make decisions without
others’ input
Make decisions and
stick by them
Given me the
opportunity to practice
ethical decision-making

B. LEADERSHIP SKILLS ALWAYS OFTEN SOMETIMES RARELY NEVER

I have become more
active in my community.
I have become a mentor
for another student.
I have taken a
leadership role in a
group project.
I have more confidence
speaking in class.
I have a better
understanding of how to
treat people.
I have knowledge of
various leadership
styles.
I feel that I
understand which
leadership style best
fits me.
I feel I could lead a
group successfully.
I am better able to
express my ideas in
group settings.
I have gained
confidence in working
with people from
different backgrounds.
I am more self-aware
and can identify and
articulate my beliefs
and values.
Lead by example
Have a strong support
staff
Prepared me to be a
leader in my community
Prepared me to be a
future leader in the
society
Exposed me to different
leadership theories
Helped me to learn more
about my own leadership
style
Familiarized me with the
best methods to use to
be a good leader
Provided opportunities
for me to gain
confidence in my
leadership abilities
Taught me how to define
success as a leader
Allowed me to view how
current leaders perform
Informed me about how to
be a better leader

C. SOCIALIZATION ALWAYS OFTEN SOMETIMES RARELY NEVER

I am friendly to others
even when I am in a bad
mood
I try to avoid conflict
with people when
possible
I try to take into
account other people’s
feelings
I try to take into
account other people’s
viewpoints even they are
very different
People confide in me
I have a good sense of
humor

PART IV. PROBLEMS MET OF GSP MEMBER

AGREE DISAGREE
Weather
Biased organizers/coordinators
Safety of activities
Risk
Not organized activities
Environment
Health safety