Sample Questionnaire
City College of Tagaytay
St. Akle St., Kaybagal South, Tagaytay City
Date:___________
Dear Students:
In order for the compliance and need to the study of our Sociology II subject, we are conducting a follow-up survey of respondents (especially youth/students) to answer some questions related to the study of behavior of mankind. Your response to this survey is crucial in providing the necessary assessment of the institution to develop the behavioral activities of students
The purpose of this survey is to determine to what extent the different factors in attitude do and study interest affects individual.
Enclosed you will find a self-addressed, stamped envelope to use when returning the survey. Please feel free to include any additional comments you deem necessary or relevant to improving the behavioral aspect of individual. Be assured that all your answers are highly confidential and will be treated with privacy. Your response and time is greatly appreciated. Thank you!
Sincerely,
Floriden Dairo
Camille Punzalan
Marilyn Vargsa
Mary Grace Romero
John Paul Bernaldez
(BSE III-B, English)
Below is a list of statements. Please indicate how you feel about each statement by checking the box of your answer.
How family background does affect your behavior and interest in study habits?
1. My parents really care for me
(_) True (_) False
2. I get along well with my parents and siblings
(_) True (_) False
3. My parents really listen to I have to say
(_) True (_) False
4. My parents care whether I come at home very late at night
(_) True (_) False
5. My parents didn’t pay attention to what I have to say.
(_) True (_) False
6. My parents didn’t appreciate my effort
(_) True (_) False
7. My parents always fight
(_) True (_) False
8. My mother always nagged me especially if we do not have enough money
(_) True (_) False
9. My parents didn’t support our studies
(_) True (_) False
St. Akle St., Kaybagal South, Tagaytay City
Date:___________
Dear Students:
In order for the compliance and need to the study of our Sociology II subject, we are conducting a follow-up survey of respondents (especially youth/students) to answer some questions related to the study of behavior of mankind. Your response to this survey is crucial in providing the necessary assessment of the institution to develop the behavioral activities of students
The purpose of this survey is to determine to what extent the different factors in attitude do and study interest affects individual.
Enclosed you will find a self-addressed, stamped envelope to use when returning the survey. Please feel free to include any additional comments you deem necessary or relevant to improving the behavioral aspect of individual. Be assured that all your answers are highly confidential and will be treated with privacy. Your response and time is greatly appreciated. Thank you!
Sincerely,
Floriden Dairo
Camille Punzalan
Marilyn Vargsa
Mary Grace Romero
John Paul Bernaldez
(BSE III-B, English)
Below is a list of statements. Please indicate how you feel about each statement by checking the box of your answer.
How family background does affect your behavior and interest in study habits?
1. My parents really care for me
(_) True (_) False
2. I get along well with my parents and siblings
(_) True (_) False
3. My parents really listen to I have to say
(_) True (_) False
4. My parents care whether I come at home very late at night
(_) True (_) False
5. My parents didn’t pay attention to what I have to say.
(_) True (_) False
6. My parents didn’t appreciate my effort
(_) True (_) False
7. My parents always fight
(_) True (_) False
8. My mother always nagged me especially if we do not have enough money
(_) True (_) False
9. My parents didn’t support our studies
(_) True (_) False
References: Durand, V. M., & Crimmins, D. B. (1992). Motivation assessment scale. Topeka, KS: Monaco & Associates Incorporated. Iwata, B. A., & DeLeon, I. G. (1995). The functional analysis screening tool (FAST). Lewis, T.J., Scott, T., & Sugai, G. (1994). The problem behavior questionnaire: A teacher-based instrument to develop functional hypotheses of problem behavior in general education Mason, S. A. & Egel, A. L. (1995). What does Amy like? Using a mini-reinforcer assessment to increase student participation in instructional activities O’Neill, R. E., Horner, R. H., Albin, R. W., Storey, K., & Sprague, J. R. (1997). Functional assessment and program development: A practical handbook Brown, S. W. (2006). Questions about behavioral function in mental illness (QABF-MI). Behavior Modification, 30(6), 739-751.