Responden

: pemerintah

No.

Tanggal

KUESIONER PENELITIAN KARAKTERISTIK INFRASTRUKTUR

Oleh :
Tim peneliti karakteristik infrastruktur desa Panggungharjo, Sewon, Bantul
Program Studi Pengembangan Wilayah
Fakultas Geografi, Universitas Gadjah Mada

Pengantar
Kuesioner ini dimaksudkan untuk keperluan penelitian, maka dengan segala
kerendahan hati, kami mohon kesediaan Saudara untuk mengisi kuesioner ini
dengan lengkap dan benar. Kerahasiaan data dijamin oleh penanggung jawab
penelitian. Atas kerja sama Saudara, kami ucapkan terima kasih.

Petunjuk pengisian
1. Isilah jawaban pada tempat yang disediakan.

Karakteristik Responden
1. Nama

: ......................................................................................

2. Alamat

: ......................................................................................

3. Jenis Kelamin

: a. Pria

4. Usia

: ......................................................................................

5. Pekerjaan

: ......................................................................................

6. Pendidikan

: a. SD b. SMP c. SMA d. Diploma d. S-1 e. S-2 f. S-3

b. Wanita

Karakteristik Infrastruktur
1. Bagaimana ketersediaan dan kondisi infrastruktur jalan dan jembatan,
terminal, stasiun, bandar udara atau pelabuhan yang ada di desa?
Infrastruktur apa saja yang tersedia?
Jawaban : .......................................................................................................
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2. Apakah terdapat masalah terkait dengan infrastruktur jalan dan jembatan,
terminal, stasiun, bandar udara atau pelabuhan yang ada? Bagaimana
solusinya?
Jawaban : .......................................................................................................
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3. Bagaimana ketersediaan dan kondisi infrastruktur listrik, telepon dan
telekomunikasi, air bersih, irigasi dan drainase yang ada di desa?
Infrastruktur apa saja yang tersedia?
Jawaban : .......................................................................................................
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4. Apakah terdapat masalah terkait dengan infrastruktur listrik, telepon dan
telekomunikasi, irigasi dan drainase yang ada? Bagaimana solusinya?
Jawaban : .......................................................................................................
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5. Apakah sudah terdapat infrastruktur pengelolaan lingkungan yang mencakup
pengelolaan

sampah,

limbah

dan

sanitasi

lingkungan?

Bagaimana

kondisinya?
Jawaban : .......................................................................................................
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6. Apakah terdapat masalah terkait dengan infrastruktur pengelolaan lingkungan
yang ada? Bagaimana solusinya?
Jawaban : .......................................................................................................
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7. Bagaimana ketersediaan dan kondisi infrastruktur pendidikan dan kesehatan
yang ada di desa? Infrastruktur apa saja yang tersedia?
Jawaban : .......................................................................................................
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8. Apakah terdapat masalah terkait dengan infrastruktur pendidikan dan
kesehatan yang ada? Bagaimana solusinya?
Jawaban : .......................................................................................................
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9. Apakah selama ini masyarakat terlibat secara aktif dalam penyediaan
infrastruktur mulai dari perencanaan, pembangunan hingga pengelolaan?
Bagaimana bentuk keterlibatannya?
Jawaban : .......................................................................................................
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10. Apakah selama ini masyarakat terlibat secara aktif dalam penyediaan
infrastruktur mulai dari perencanaan, pembangunan hingga pengelolaan?
Bagaimana bentuk keterlibatannya?
Jawaban : .......................................................................................................
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