A Survey Questionnaire for Students

Dear Respondents:

The undersigned students are presently conducting a research paper titled, “Factors
Affecting the Achievement level of the Working students of Josefina H. Cerilles State College-
Tukuran External Studies Unit (Jhcsc-Tukuran Esu)” as a degree requirement.

We are asking for your cooperation by answering the questionnaire needed to complete
this study. Please feel free to answer the following questions. Rest assured that all information
will be kept confidential.

We will always be grateful for your utmost support and cooperation.

Very truly yours,

The Researchers
 FACTORS AFFECTING THE ACIEVEMENT LEVEL OF THE WORKING STUDENTS OF JOSEFINA H.
CERILLES STATE COLLEGE-TUKURAN EXTERNAL STUDIES UNIT (JHCSC-TUKURAN ESU)
Questionnaire
The purpose of the survey is to collect data and analyze the factors affecting the academic
performance of working students.

Name of the Students: (optional):

Sex:

Current Level of Education:

GWA in First Semester SY 2016:

GWA in Second Semester SY 2017:

Directions:

Please check and rate yourself honestly based on what you actually do, give the
statement using the following scales:

4- Always 3-Often 2-Sometimes 1-Never

A. Student-Guardian Relationship-Related Factors 1 2 3 4

1. My guardian motivates me to study well.

2. They won’t let me go to school unless my work is done.

3. They treated me as their own child.

4. They keep on reprimanding me when I went home late.

5. My guardian cultivates good relationship.

6. My guardian fails to provide my needs.

7. They immediately give me money for my projects.

8. My guardian will not let me attend every activity in school.

9. My guardian do pays my obligation in school.

10. My guardian do not promoted the sense of belongingness.

B. Time Management-Related Factors 1 2 3 4

1. I pass my projects on the said deadline.

2. I came late in school.

3. I get high scores during quizzes and examinations.

4. I cannot concentrate on the discussions.

5. I can manage my time well.

6. I have less time to do my projects and assignment.

7. I have ample of time to study my lessons.

8. Undone works at home affects my concentration in the

school.

9. I give importance to my study.

10. I failed to come to school because of tiredness.