Survey Questionnaire for the Involvement of Students in Community Action

Dear Student,

This survey intends to determine your initial level of involvement as students in community engagement.
In view of this, your utmost honesty, cooperation, and participation by answering all the items the needed
information in this questionnaire are hereby requested. Rest assured that your answers will be treated confidentially
and will be used solely for enriching the lesson.

Your cooperation will be highly appreciated.

Truly yours,

RONALD A. AÑONG
Community Engagement Subject Teacher

NAME: _____________________________ YR. & SEC.:___________________ DATE:______________

Part I. Reasons for Involvement

Direction: This evaluation is to appraise your reasons for prospective involvement in a community action by encircling
the appropriate score. Choose your answer from the listed alternatives:
Weighted Mean Point Scale Descriptive Rating Interpretation
4.21 – 5.00 5 Always Highly Considered
3.41 – 4.20 4 Often Considered
2.61 – 3.40 3 Fair Moderately Considered
1.81 – 2.60 2 Seldom Less Considered
1.00 – 1.80 1 Never Not Considered

Indicators Scale
1. Make important networking contacts 5 4 3 2 1
2. Learn or develop skills 5 4 3 2 1
3. Teach your skills to others 5 4 3 2 1
4. Enhance your résumé 5 4 3 2 1
5. Gain work experience 5 4 3 2 1
6. Build self-esteem and self-confidence 5 4 3 2 1
7. Improve your health 5 4 3 2 1
8. Meet new people 5 4 3 2 1
9. Feel needed and valued 5 4 3 2 1
10. Express gratitude for help you may have received in the past from an organization
5 4 3 2 1
11. Communicate to others that you are ambitious, enthusiastic and care about the
5 4 3 2 1
community
12. Make a difference in someone’s life 5 4 3 2 1
13. Improves the likelihood your children will volunteer as an adult 5 4 3 2 1
14. Other ________________________ 5 4 3 2 1

Part II. Interests

Direction: This evaluation is to appraise your interests for having a prospective involvement in a community action
by encircling the appropriate score. Choose your answer from the listed alternatives:
Weighted Mean Point Scale Descriptive Rating Interpretation
4.21 – 5.00 5 Always Highly Interested
3.41 – 4.20 4 Often Interested
2.61 – 3.40 3 Fair Moderately Interested
1.81 – 2.60 2 Seldom Less Interested
1.00 – 1.80 1 Never Not Interested

Indicators Scale
1. Politics 5 4 3 2 1
2. Energy / Environment 5 4 3 2 1
3. Advocacy 5 4 3 2 1
4. Education 5 4 3 2 1
5. Health Care 5 4 3 2 1
6. Housing / Homeless 5 4 3 2 1
7. Veterans 5 4 3 2 1
8. Children 5 4 3 2 1
9. Animals 5 4 3 2 1
10. Conservation 5 4 3 2 1
11. Safety and Security 5 4 3 2 1
12. Other ________________________ 5 4 3 2 1
Part III. Skills
Direction: This evaluation is to appraise your skills beneficial in conducting a prospective involvement in a community
action by encircling the appropriate score. Choose your answer from the listed alternatives:
Weighted Mean Point Scale Descriptive Rating Interpretation
4.21 – 5.00 5 Always Highly Skilled
3.41 – 4.20 4 Often Skilled
2.61 – 3.40 3 Fair Moderately Skilled
1.81 – 2.60 2 Seldom Less Skilled
1.00 – 1.80 1 Never Not Skilled

Indicators Scale
1. Computer literate 5 4 3 2 1
2. Typing 5 4 3 2 1
3. Sales 5 4 3 2 1
4. Construction 5 4 3 2 1
5. Teaching 5 4 3 2 1
6. Proficient in American Sign Language 5 4 3 2 1
7. Engine Repair 5 4 3 2 1
8. Management 5 4 3 2 1
9. Artistic 5 4 3 2 1
10. Athletic 5 4 3 2 1
11. Cooking 5 4 3 2 1
12. Other ________________________ 5 4 3 2 1

Part IV. Special Needs

Direction: This evaluation is to appraise your special needs in conducting a prospective involvement in a community
action by encircling the appropriate score. Choose your answer from the listed alternatives:
Weighted Mean Point Scale Descriptive Rating Interpretation
4.21 – 5.00 5 Always Highly Needed
3.41 – 4.20 4 Often Needed
2.61 – 3.40 3 Fair Moderately Needed
1.81 – 2.60 2 Seldom Less Needed
1.00 – 1.80 1 Never Not Needed

Indicators Scale
1. No crowds/ loud noises 5 4 3 2 1
2. Accessibility 5 4 3 2 1
3. Medical Needs – equipment, medicines, etc. 5 4 3 2 1
4. Stamina 5 4 3 2 1
5. Other ________________________ 5 4 3 2 1

* Adapted from “Making a Difference: How to Become and Remain Active in Your Community”. Retrieved from
http://www.state.sc.us/dmh/client_affairs/volunteer_guide.pdf