Informed Consent

Introduction
We are students of De La Salle – College of Saint Benilde. I would like to invite you to take part on the
survey that I am conducting in partial fulfillment in the course Science Technology and the Society. You
are given ample time to reflect and answer the survey. Please feel free to ask question/s at any time
should you need to have clarifications about the survey.

Purpose and duration of the survey

Waste management has always been a global concern. Included in this concern is the proliferation of
electronic wastes (e-wastes). The results in this survey will be used for class presentation, school
presentation and will eventually be used for research.
E-waste is any electrical or electronic equipment that's been discarded. This includes working and
broken items that are thrown in the garbage or donated which are not properly recycled or disposed of.
This short survey is about how electronic wastes are treated in the households and your household is
selected to take part of this survey. It also intends to gather information how the pandemic affects the
accumulation of e-wastes in the country. The survey will only last for 5 to 10 minutes

Confidentiality
The information that you will provide will be treated with utmost confidentiality. Your name will be
removed from all records involved in the survey.

You may email me in case you have any inquiries after the survey.

Personal Information:

Name: (required)

Email address: (required)

Number of members in the household: (required, multiple choice)

2
3
4
5
6>

Average monthly income of the household (Php) (required, multiple choice)

20,000 and below
20,001 to 40,000
40,001 to 60,000
60,001 to 80,000
80,001 to 100,000
100,001 to 150,000
 150,001 to 200,000
200,001 and above

General Information about e-waste

What gadget do you personally own? (required, multiple answer)

Personal computer
Laptop
Tablet
Smart phones
Wearables
Home electronics (TVs, kitchen appliances, light bulbs, etc)
Personal electronics (gaming systems, AVR, etc)
Miscellaneous (power banks, chargers, trinkets, batteries)

How many of these gadgets are in use? (Required, Multiple answers)

PC Laptops Tablets Smart phones Home elec Personal elec Miscellaneous

1
2
3
4
5

How often do you replace your gadgets? (Required, Multiple answers)

PC Laptops Tablets Smart phones Home elec Personal elec Miscellaneous

<1 year
1 year
2 years
3 years
4 years
5>years

Did you purchase any of the following gadgets from January 2020 to present? If so, how many? (not
required, multiple answers)
Personal computer Laptops Tablets Smart phones TVs

1
2
3
4
5

What was the reason for your purchase? (not required, multiple answer)
 On-line learning
Work-from-home
Online business
To communicate with family/relatives and friends
New app
Others, please state the reason:

Awareness on E-waste management

If the gadget is not functional, what do you do? (required, multiple choice)
Repair
Replace

How do you treat your e-waste? Assume that repair is NO LONGER an option (not required, multiple
answer)
PC Laptops Tablet Smart phones Home elec Personal elec Miscellaneous
Recycle

Throw away

Keep at home

Donate

Resell

On the scale of 0 to 4, how much do you know about e-wastes recycling? (required, multiple choice)
0 - I know nothing
1 - I know a little
2 - I know more than average
3 – I know quite a lot
4 – I know about all the stages

Do you participate in e-waste recycling? (required, multiple choice)

Yes
No

On the scale of 0 to 4, how much do you know about valuable materials contained in most e-wastes?
(required, multiple choice)
0 - I know nothing
1 - I know a little
2 - I know more than average
3 – I know quite a lot
4 – I know about all its components

If you keep you e-wastes at home, how long do you store your e-wastes? (required, multiple choice)
 <1 year
1-2 years
2-3 years
3-4 years
4-5 years
6 > years

Are you aware of the danger in storing your e-wastes at home? (required, multiple choice)
Not that I am aware of
Not sure
I have an idea
Yes, but I ignore
Yes, I am perfectly aware

On a scale of 0 to 4, how much do you know about proper disposal of e-wastes? (required, multiple
choice)
0 – I have no idea
1 – I dispose them together with all other wastes
2 – I dispose them together with my dry wastes
3 – I dispose them together with other recyclables
4 – It has to be disposed separately from all other e-wastes

On the scale of 0 to 4, how much do you know about agencies/programs collecting and recycling e-
wastes? (required, multiple choice)
0 – I have no idea
1 – I know a little
2 – I know more than average
3 - I know quite a lot
4 - I know many of them and participate in their collection

How much do you know about collection sites in malls? (required, multiple choice)
0 – I have no idea
1 – I know a little
2 – I know more than average
3 - I know quite a lot
4 – I know many of them and bring some my e-wastes there

How much do you know about collection sites in school? (required, multiple choice)
0 – I have no idea
1 – I know a little
2 – I know more than average
3 - I know quite a lot
4 – I know where the collection bins are and dispose of my e-wastes there

If there were convenient collection/drop off sites, how likely will you participate in disposing your e-
wastes there? (required, multiple choice)
 0 - I will not participate
1 - I do not know what I will do
2 - I will consider participating
3 – I will participate depending on the location
4 – I will definitely participate

How much do you know about Philippines laws about e-wastes? (required, multiple choice)
0 – I have no idea
1 – I know a little
2 – I know more than average
3 - I know quite a lot
4 – I know about the laws and I follow them

Do you agree that the manufacturers should shoulder the expenses on e-waste recycling processes?
(required, multiple choice)
0 – I have no idea
1 – I strongly disagree
2 – I disagree
3 – I agree
4 – I strongly agree

Do you agree that the retailers should shoulder the expenses on e-waste recycling processes? (required,
multiple choice)
0 – I have no idea
1 – I strongly disagree
2 – I disagree
3 – I agree
4 – I strongly agree

Do you agree that the consumers should shoulder the expenses on e-waste recycling processes?
(required multiple choice, multiple choice)
0 – I have no idea
1 – I strongly disagree
2 – I disagree
3 – I agree
4 – I strongly agree

Your participation in this survey is greatly appreciated. I will share with you the results of this
survey together with relevant information of the proper e-waste management.

Take care and God bless us all!