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APPENDIX

Appendix 1

REQUEST FORM

(Men cause violence)

Hello. I am doing a research project with the aim of improving social work services with men to build good family relationships in Quang Ninh.

You have been selected to participate in our research. I would appreciate your time to answer a few questions. All information you provide will be kept strictly confidential. You have the right to stop the interview at any time or not answer any questions you do not wish to answer. Your opinions will be respected. Some of the topics we will ask about may be difficult to discuss, but many people have said that this is an opportunity to talk about these things. Your participation is very important to the success of this survey.

Please provide some personal information:

Personal information

A1. How old are you this year: …………………… A2. Ethnicity: ………………………………………….

A3. Place of residence: 1) Van Don 2) Hai Ha 3) Ha Long A4. Education level: 1, Primary school

2, Middle School

3, High School 4, College

5, University

6, University degree or higher

A5. Your average monthly income in the past year:

1, Under 3 million

2, From 3 - 5 million

3, From 5 - 10 million