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Sample Questionnaire
Leon Guinto Memorial College, Inc.
Atimonan, Quezon

January 21, 2010

Dear Teacher,

The undersigned is presently conducting a study entitled “The Level of Academic Performance of Multigrade Pupils in Angeles Elementary School during the School Year 2010 – 2011.”

In this connection, please feel free in answering the questionnaire – checklist. Please never leave any item unanswered. In accordance with the ethics of research, your answers will be treated with utmost confidentiality.

Thank you very much for your cooperation.

Very truly yours,

Jhon Paulo V. Oflaria Researcher

QUESTIONNAIRE – CHECKLIST FOR TEACHERS

Name: ____________________________________________________________

_

Address: ___________________________________________________________

Sex: _________

Date of Birth: __________

Salary Grade: __________

Years of teaching experience: (Please check)

1 to 5 years 11 to 20 years

6 to 10 years more than 20 years

Educational Qualification: (Please check)

Master’s Degree

Bachelor’s Degree with 20 or more units leading to Master’s Degree

Bachelor’s Degree with less than 20 M.A. / M. S. units

Bachelor’s Degree

Leon Guinto Memorial College, Inc.
Atimonan, Quezon

January 21, 2010

Dear Parent,

The undersigned is presently conducting a study entitled “The Level of Academic Performance of Multigrade Pupils in Angeles Elementary School during the School Year 2010 – 2011.”

In this connection, please feel free in answering the questionnaire – checklist. Please never leave any item unanswered. In accordance with the ethics of research, your answers will be treated with utmost confidentiality.

Thank you very much for your cooperation.

Very truly yours,

Jhon Paulo V. Oflaria Researcher

QUESTIONNAIRE-CHECKLIST FOR PARENTS

Pangalan ng mga Magulang:

Ama: ____________________________________________________________

___

Ina: ____________________________________________________________

____

Pangalan ng Anak na Nag aaral: _______________________________________

Kasarian: ____________________ Kapanganakan: ______________________

Kita ng Pamilya kada Buwan

Mas mababa sa P 5,000

5.001 hanggang P 10,000

Mas mataas sa P 10, 000

Birth Order ( Pang ilan sa Mag kakapatid ang batang nag aaral)

Una Ikalawa Ikatlo Ika apat

Ika lima Ika anim Ika pito Ika walo

Ika siyam Ika sampu ________

Natapos na Pag aaral ng Magulang

Ama Ina
___ College Graduate ___ College Graduate

___ College Undergraduate ___ College Undergraduate

___ High School Graduate ___ High School Graduate

___ High School Undergraduate ___ High School Undergraduate

___ Elementary Graduate ___ Elementary Graduate

___Elementary Undergraduate ___ Elementary Undergraduate

___________________________ __________________________ Lagda ng Ama Lagda ng Ina
Leon Guinto Memorial College, Inc.
Atimonan, Quezon

January 21, 2010

Dear Teacher,

The undersigned is presently conducting a study entitled “The Level of Academic Performance of Multigrade Pupils in Angeles Elementary School during the School Year 2010 – 2011.”

In this connection, I further request to have a copy of selected pupil’s latest grades from their Report card and nutritional status. In accordance with the ethics of research, records will be treated with utmost confidentially.

Thank you very much for your cooperation.

Very truly yours,

Jhon Paulo V. Oflaria Researcher

Leon Guinto Memorial College, Inc.
Atimonan, Quezon

January 21, 2010
Carlito M. Bautista
Head Teacher
Angeles Elementary School
Atimonan, Quezon

Sir,

This is to request permission from your good office to administer questionnaires to the multigrade teachers of Angeles Elementary School. I further request to have a copy of Report Card and Nutritional Status in relation to our research study entiltled “The Level of Academic Performance of Multigrade Pupils in Angeles Elementary School during the School Year 2010 – 2011.”

Thank you very much for your cooperation.

Very truly yours,

Jhon Paulo V. Oflaria Researcher

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