Patterned to cater to the Sustainable Development Goals

1 End poverty in all its forms everywhere (Acknowledging that poverty in its many forms has yet
to be fully addressed, local government policies should be geared towards creating programs
designed to cater to the specific needs of their most economically and socially challenged
constituents by way of producing social welfare and protection programs, as well as
empowering them to participate in capacity-building and skills-training initiatives)
2 End hunger, achieve food security and improved nutrition and promote sustainable
agriculture
3 Ensure healthy lives and promote well-being for all at all ages
4 Ensure inclusive and equitable quality education and promote lifelong learning
opportunities for all
5 Achieve gender equality and empower all women and girls
6 Ensure availability and sustainable management of water and sanitation for all
7 Ensure access to affordable, reliable, sustainable and modern energy for all
8 Promote sustained, inclusive and sustainable economic growth, full and productive
employment and decent work for all
9 Build resilient infrastructure, promote inclusive and sustainable industrialization and foster
innovation
10 Reduce inequality within and among countries
11 Make cities and human settlements inclusive, safe, resilient and sustainable (Urban planning
and development, organizing public transportation, creating and promoting the usage of public
spaces, prioritizing disaster risk reduction and management)
12 Ensure sustainable consumption and production patterns (sustainable tourism, waste
management, natural resource consumption assessment)
13 Take urgent action to combat climate change and its impacts* (Climate change awareness,
conservation, and protection of oceans, seas, and marine resources as well as terrestrial
ecosystems, forests
14 Conserve and sustainably use the oceans, seas and marine resources for sustainable
development
15 Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage
forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss
16 Promote peaceful and inclusive societies for sustainable development, provide access to
justice for all and build effective, accountable and inclusive institutions at all levels
Last Name:___________________ First Name:_______________________________ M.I.:____
Address:____________________________________City:___________Province:____________
Birthdate:__ /__ /____ Age:__ Gender: M / F Religion:________________

Youth Sector: Student / Young Professional / Out-of-School Youth

Are you a part of a minority group? If yes, please indicate:_____________

Participant’s Survey:
A. Which of the following issues do you think your local government policies should
prioritize? List down the top five (5) most relevant themes from the choices below:

o Poverty
o Healthcare, PWDs, and Mental Health
o Equality, Gender, and Civil Rights
o Education and Employment Programs
o Energy Alternatives (Affordable, reliable, sustainable, and environmentally-sound
alternative energy sources)
o Urban and Rural Infrastructure Development,
o Tourism
o Environment and Natural Resources
o Peace and Security
o Strengthening Political Institutions
o Disaster Risk Reduction and Management

1.
2.
3.
4.
5.

B. Among the top five choices above, provide three (3) issues regarding each theme which
you think is prevalent in your community. Mark the most critical issue for each theme
with an asterisk (*).

1. Theme 1 b. Issue 2:
a. Issue 1*: c. Issue 3*:
b. Issue 2: 4. Theme 4
c. Issue 3: a. Issue 1:
2. Theme 2 b. Issue 2*:
a. Issue 1: c. Issue 3:
b. Issue 2*: 5. Theme 5
c. Issue 3: a. Issue 1*:
3. Theme 3 b. Issue 2:
a. Issue 1: c. Issue 3:
 C. Among the issues above, which issue would you like to focus on and provide a solution
to, and why?
o _____________________________________________________________________
_____________________________________________________________________

D.
Civil Society Youth Participation Perception Before After Perception
1 – Strongly Disagree; 2 – Disagree; 3 – Program Program Differential
Unsure; 4 – Agree; 5 – Strongly Agree
I am familiar with our local government unit’s
legislative mechanism
I believe that the youth should actively participate
in civil society engagements
I am aware of the issues and problems that affect
the youth in our community
I believe that I am capable of positively
contributing solutions to the issues and problems
surrounding the youth in our community
I am interested in being able to engage myself in
providing insights that would positively assist in
coming up with solutions to the issues and
problems of the youth in our community
I believe that these solutions can bring about
programs and policies which will be able to help
the youth in our community
Leadership Potential Perception Before After Perception
1 – Hesitant; 2 – No Ability; 3 – Little Ability; 4 Program Program Differential
– Satisfactory Ability; 5 – Exceptional Ability
I am eager to engage in group discussions with my
peers
I am comfortable with being able to share and
explain my ideas
I am willing to listen to the ideas of others
I am open to the criticism of others
I am creative and resourceful
I believe I have the capacity to lead in various
activities

The Model City Council not only promotes a competitive environment where solutions for issues
and problems regarding the youth can be created, fostered, and shared. It also makes sure that
fundamental leadership skills can be developed and honed by each and every single participant.