1.

Name(Optional)

* 2.

Gender?

Male

Female

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* 3.

Age?

15 - 17

18 - 20

21 and above

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* 4.

Do you speak in the public before?

Yes

No

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* 5.

Do you like to speak in the public?

Yes

No

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* 6.

How well do you speak in the public?

Not very well

Satisfactory

Very well

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* 7.

Do you have problem speaking in the public?

Yes

No

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8.

 

* 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

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* 10.

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

Yes

No

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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?

Yes

No

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* 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 Agree	Agree	Neutral	Disagree	Strongly 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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