Direction: Please fill in the blanks or check the boxes or parentheses provided below that best correspond to your answer
SOP I. Personal Profile
1.1 Name: (optional):_______________________
1.2 Age
___0-15 years old or below ___46-60 years old
___16-30 years old ___60 years old or above
___31-45 years old
1.3 Civil Status
___Single ___Separated
___Married ___Widow/er
1.4 Number of Dependents:
___4-6 ___10 or above
___7-9
1.5 Educational Attainment
___Elementary ___College Graduate
___High-school ___vocational
1.6 Occupation
___None ___Regular
___Contractual ___Others (Please specify)________________
1.7 Average monthly earnings
___ 2,500 Php or below ___ 7,501-10,000 Php
___2,501-5,000 ___10,000 Php or above
___5,001-7,500 Php
1.8 Assets owned
___ Television ___ Washing machine
___Electric fan ___Gas stove
___Computer ___Others (please specify)___________________
1.9 Cash Grants Received
___500 Php ___1,100 Php
___800 Php ___1,400 Php or more
Part II. How do the beneficiaries allocate in their daily living the following: 2.1 Monthly income 2.2 Cash Grants from the 4Ps
2.1 Where do you spend your monthly income?
___Food ___Health
___Shelter ___Clothing
___Education ___Others (please specify)____________________
2.2 Where do you spend your Cash Grants from the 4Ps?
___Health care program ___Others (please specify)____________________
(Note: Specific questions about how the beneficiaries allocate their earnings and cash grants will be asked during the interview)
PART III. How does the DSWD monitor the progress of the beneficiaries of the program in terms of: 3.1 Following the condition 3.2 Alleviating from poverty 3.3 Health status 3.4 Education status 3.5 Maternal health
3.1 How often does the DSWD monitor your progress during the 4Ps program?
___Regularly ___Frequently
___Seldom
PART IV Based on the recipient’s experience, to what extent is the contribution of the 4Ps