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The Example of Questionnaire
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QUESTIONNAIRE
This Questionnaire has the purpose to identify the correlation between the habit of watching English subtitle movie and Reading Comprehension achievement. All of the questions are for any movie or serial which uses English as the subtitle. Please be honest in answering every single of question. This questionnaire is purely for conduct a thesis in order to get the data. It will not affect your score mark at the certain lesson. The last, your data will be private for the researcher only. Thank you.

Name | : ______________________ | NIM | : _______________________ | Gender | : ______________________ | Class | : _______________________ | Age | : ______________________ | Academic Year | : _______________________ | Address | : ______________________ | Contact No. | : ______________________ |

General Question
Have you watched at least 1 movie with english subtitle in the past of two years? a. Yes b. No.

Specific Question 1. How many movies with english subtitle that you watch in a month? a. More than 10 titles b. 8 – 10 titles c. 5 – 7 titles d. 2 – 4 titles e. Only 1 title 2. For the movie with multiple episode (serial), how many episodes that you watch in a month? a. More than 30 episodes b. 21 – 30 episodes c. 13 – 20 episodes d. 5 – 12 episodes e. 1 – 4 episodes 3. How often do you watch movie with english subtitle? a. Every single day (no day without movie) b. Almost everyday c. Twice or third in a week d. Once a week e. Once a month 4. How many times do you spend for watching movie with english subtitle in a day? a. More than 5 hours b. Around 5 hours c. Around 3 – 4 hours d. Around 2 hours e. Less than an hour 5. Rank the reasons of watching movie with english subtitle on it: Habitual | 1 | 2 | 3 | 4 | 5 | Curious the cultural life as seen as on the movie | 1 | 2 | 3 | 4 | 5 | Like the storyline or the topic of the

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