Technical Education and Skills Development Authority
JACOBO Z. GONZALES MEMORIAL SCHOOL OF
ARTS AND TRADES
Region IV-A
San Antonio, City of Biñan, Laguna
Data Gathering Instrument for Trainee’s Characteristics
Name: ________________ Date: _____________
Qualification: _________________________________________
Instruction:
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 and Average grade in: Average grade in:
numeracy (LL&N) English Math
a. 95 and above f. 95 and above
b. 90 to 94 g. 90 to 94
c. 85 to 89 h. 85 to 89
d. 80 to 84 i. 80 to 84
e. 75 to 79 j. 75 to 79
Cultural and language Ethnic group: Language Spoken:
background a. Tagalog Please specify:
b. Cebuano _Filipino,English_________
c. Ilocano ______________________
d. Hiligaynon _______________
e. Bicolano
f. Waray Tribal group: if any
g. Moro __________________
h. Others: please
specify_____________
Education & general Highest Educational Attainment:
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
Sex a. Male
b. Female
Age Your age: _____
Physical ability I. Disabilities(if any)_____________________
II. Existing Health Conditions (Existing illness if any)
a. None
b. Asthma
c. Heart disease
d. Anemia
e. Hypertension
Characteristics of Learners
f. Diabetes
g. Others(please specify) __________________
Previous experience Electronic Product Assembly and Servicing NCII
with the topic Certificates
a. Electronic technician
b. Electronic laboratory assistant
c. Electronic shop owner / assistant
Number of years in the job related to EPAS___
d. None
Previous learning List down trainings related to Computer
experience a. Others(please specify) __________________
Training Level National Certificates acquired and NC level
completed
a. Electronic Product Assembly and Servicing NC II
b. Computer System Servicing NC II
c. Mechatronics NC II
d. Others (Please specify) _______________
e. None
Special courses Other courses related to Electronic Product Assembly and
Servicing NC II
a. Basic Electronic Troubleshooting
b. Electronics and Communication Engineering
c. Industrial Electronics Training
d. Basic Electronic and Circuits Training
e. Others (Please specify) __________________
f. None
Learning style 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 - described as the students in the
classroom, who have problems 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.
Other needs a. Financially challenged
b. Working student
c. Solo parent
d. Others(please specify)________________________
Prepared by:
Violeta M. Llenas
EPAS- Instructor
