MULTIVERSITY
OF SUCCESS COUNSELING & VIGILANCE WING STUDENT’S SURVEY:
9820044254 / 9870044254
multiversityofsuccess@yahoo.com
Questionnaire for Students:
1.
At what age did you start going
to school? ______________________________________
2.
How many siblings do you have? _____________________________________________
3.
Do you live in a joint family? _________________________________________________
4.
Are you friendly with your
mother? ____________________________________________
5.
Are you friendly with your
father? _____________________________________________
6.
Do your parents have good
relation with each-other? _____________________________
7.
Do you need to take medicines
at least once a month? ___________________________
8.
How many times a month do you
eat out? ______________________________________
9.
Do you wear spectacles /
contact lenses? If yes, state the power. _________________________
10.
Does anyone in your family have
any other chronic problem? ___________________________
11.
Do you have any terminally ill
person in family? __________________________________
12.
Do you have any heart patient
in your family? ______________________________________
13.
Do you have any diabetes
patient in family? _______________________________________
14.
Do you know about the basic
laws of land? _______________________________________
15.
Do you help people to get their
rights? ______________________________________________
16.
Do you know your consumer
rights? ________________________________________________
17.
Do you listen to music while
studying?_______________________________________________
18.
Do you keep your house neat and
clean? ___________________________________________
19.
Do you take care of your diet
& nutrition?_____________________________________________
20.
Do you exercise regularly?_______________________________________________________
21.
Do your parents spend
adequately on your needs? ____________________________________
22.
Do your parents spend
adequately on your study? ______________________________________
23.
Do you have good friends? If yes,
state their age group. _________________________________
24.
Are you in any serious
relationship? _________________________________________________
25.
Have you set a goal of your
career? _________________________________________________
26.
Do you have any hobby? If yes,
name it. ______________________________________________
27.
Do you have any pets? If yes,
give details. ___________________________________________
28.
What amount do you want to earn
monthly when you start earning? _________________________
29.
Do you wish to go abroad for
study? _________________________________________________
30.
Do you wish to settle abroad? If
yes, which country? ____________________________________
Personal details of the student:
NAME: __________________________________________________________________________________
ADDRESS: _______________________________________________________________________________
________________________________________________________________________________________
TEL. & MOBILE NO.: _______________________________________________________________________
EMAIL ID: ________________________________________________________________________________
DATE OF BIRTH: __________________________________________________________________________
EDUCATIONAL QUALIFICATION &
PROFESSION OF MOTHER: _____________________________________
EDUCATIONAL QUALIFICATION &
PROFESSION OF FATHER: ______________________________________
YEARLY FAMILY INCOME: ___________________________________________________________________
COLLEGE ATTENDED: ______________________________________________________________________
DETAILS OF YEAR & COURSE
STUDIED: _______________________________________________________
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