1.

Name(Optional)

*2.

Gender?

 Male
 Female
*3.

Age?

 15 - 17
 18 - 20
 21 and above
*4.

Do you speak in the public before?


*5.

Do you like to speak in the public?


*6.

How well do you speak in the public?

 Not very well
 Satisfactory
 Very well
*7.

Do you have problem speaking in the public?

 Yes
 No
  8.

*****From Question 7*****

*If yes please answer the question in the box *If no please proceed to another question.

 

What are the reasons of having this anxiety?

 

*9.

What's on your list? When you start speaking in the public?

 Read it
 Don't look at audience
 Rush through it
 Skip portions of my talk
 Tell myself it'll be over soon
 Imagine audience in their underwear
 Cough, pretend to have a sore throat
 Use a lot of slides
 Clench fists beneath lectern
 Keep swallowing, to make sure I can drink fluids
 Wear my lucky shirt
*10.

Do you think there’s a way to conquer the fear of public speaking anxiety?


  11.

 ********From question 10********

 What is your suggestion to conquer the fear of public speaking?

*If yes please answer the question in the box *If no please proceed to another question.

*12.

What you will do usually before you start your presentation?

*13.

Will you get phobia after you have done your presentation?


*14.

Let’s say you are giving a speech next week. There will be an audience of approximately 50 men and 50 women. Your speech has been rehearsed and studied.

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
You consider yourself to be an exceptional speaker and are not at all nervous.
You are hoping that nothing goes wrong with your speech.
You feel comfortable and secure about giving the speech.
You are really nervous and you hope the next week goes by really slow.
You are worried that the audience will be disappointed with your performance.
You feel concerned about performing poorly and choking under pressure.
You feel jittery, scared, and uncomfortable.

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