Survey Form

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SURVEY FORM ROAD SAFETY IN MALAYSIA SECTION A : DEMOGRAPHIC OF THE SURVEY PARTICIPANT 1. Profession : [ ] Students [ ] Parents [ ] Others................................. 2. Sex : [ ] Male [ ] Female 3. Race : [ ] Melayu [ ] Cina [ ] India [ ] Others................................. 4. Age (years) : [ ] Under 20 [ ] 20-25 [ ] 26-30 [ ] Over 30 5. Type of vehicle : [ ] Car [ ] Motorcycles [ ] Bus [ ] Others................................. 6. Highest academic qualification : [ ] PMR [ ] SPM [ ] STPM [ ] Diploma [ ] Bachelor [ ] Master [ ] PhD SECTION B: The questions in this activity are designed to stimulate discussion of road safety and to identify the most vulnerable road users of road fatalities. Please answer the following questions. 1. Do you know the purpose of road safety? yes or no? If yes specify??

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Transcript of Survey Form

Page 1: Survey Form

SURVEY FORMROAD SAFETY IN MALAYSIA

SECTION A :DEMOGRAPHIC OF THE SURVEY PARTICIPANT

1. Profession :[ ] Students[ ] Parents[ ] Others.................................

2. Sex :[ ] Male[ ] Female

3. Race :[ ] Melayu[ ] Cina[ ] India[ ] Others.................................

4. Age (years) :[ ] Under 20[ ] 20-25[ ] 26-30[ ] Over 30

5. Type of vehicle :[ ] Car[ ] Motorcycles[ ] Bus[ ] Others.................................

6. Highest academic qualification :[ ] PMR[ ] SPM[ ] STPM[ ] Diploma[ ] Bachelor[ ] Master[ ] PhD

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SECTION B:

The questions in this activity are designed to stimulate discussion of road safety and to identify the most vulnerable road users of road fatalities. Please answer the following questions.

1. Do you know the purpose of road safety? yes or no? If yes specify??

2. What kind of vehicle do you currently drive?

3. How often do you drive (days in a week)?

4. Do you have a driver's licens?

5. In your opinion, what kind of road users is most vulnerable to fatal accidents ?

6. Based on the answers given, state why you choose the type of road users?

7. Apart from road user types in select, specify three types of vehicles or other road users that you feel most at risk of a fatal accident?

8. Heavy trucks, motorcycles, passenger cars, pedal cyclists, buses, pedestrians. Set vehicles or road users are given in the order you think is most at risk of a fatal accident?

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SECTION C:

This question about the causes of fatal accidents, especially to road users. Using the five –point likert scale below.

Strongly Disagree Disagree Neutral Agree Strongly angree 1 2 3 4 5

1. The main cause of the accident caused the negligencedrivers of road users . Exmple the attitude of road users.

1 2 3 4 5

2. Majority of road users do not wear motorcycle helmets and not complying with road.

1 2 3 4 5

3. Other causes of accidents are vehicle problems. Examples such as a flat tire, do not modify the terms and many others.

1 2 3 4 5

4. In addition, due to the road conditions are not good and perforated.

1 2 3 4 5

5. Weather conditions are also a cause of the accident toheavy vehicles

1 2 3 4 5

6. Road users such as heavy vehicles and bus accidents arenot caused enough rest and sleep time driving.

1 2 3 4 5

7. Whether due to deficiency road law is the cause of the accident?

1 2 3 4 5

8. Taking prohibited substances such as drugs, alcohol while driving causes accidents

1 2 3 4 5

9. The use of mobile phones while driving one of the causes of road accidents

1 2 3 4 5

10. Accidents caused by pedestrians attitude and pedestriansdo not use it right channel.

1 2 3 4 5

SECTION D:

In your opinion, what steps can be taken to overcome the problem of accidents on the roads, especially for road users ?

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