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Personal Information Survey

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
1

Full Name

Enter your full name
2

Gender

Select your gender
3

Contact

Enter your contact number
4

Occupation

Specify your occupation
5

Address

Enter your complete address
6

Purok

Specify your purok
7

Question 7

This is a star rating question
8

Question 8

This is a single choice question
9

Question 9

This is a text answer question
10

Question 10

This is a star rating question with 5 stars