Republic of the Philippines

Commission on Higher Education

Don Honorio Ventura Technological State University
Bacolor, Pampanga
College of Engineering and Architecture
Department of Civil Engineering
Probability and Statistics
Research Work in Math 313a

Drowsy Dilemma
Name: ___________________________________________ Course: ____________

Age: _______ Gender: ____________

Put a check on the box that represents your answer.

A. Do you atleast sleep eight (8) hours a day?

Yes No

B. Time of sleep. (What time do you usually sleep?)

7:00 9:00 pm 9:00 11:00 pm
11:00 pm 1:00 am 1:00 4:00 am 4:00 am onwards

C. Factor/s affecting your time of sleep

Studies
Gadget Usage
Sleep Disorder
(Optional) indicate: __________________
Others: Please specify ______________________

D. Does sleeping at the time you answered in letter A affects your studies?
Yes No

If Yes, Why?
________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

E. Rate us from 1 5 (5 being the highest)

5 4 3 2 1

Thank You for your Time!

_________________________________
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