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GENERAL INFO: This Questions is about students failing grades because of parents separation.
Name: ___________________________________________
Section:__________________________________________
Age:____________________________________________
QUESTIONS YES NO
1. Are you insecure in the other family?
2. Are your parents tutoring you?
3. Are your parents married before?
4. Are your parents taking care of you?
5. Does your mother and father have good relationship now?
6. Do you want to stop your school because of your parents
separation?
7. Do you want your parents to get back together?
8. Does your parents separation have any negative effects
on your study?
9. Do you want to finish your study even if your parents
were separated?
10.Have you tried to rebel because of your situation?