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A. Introduction
B. Questions
Name:
Age: Sex:
Educational Background:
Elementary:
High School:
College:
Mother:
Occupation: Monthly Salary:
Father:
Occupation: Monthly Salary:
The following factors which can affect the study habits of students are listed. To
what extent would you agree to the following? Please put a check ( ) mark under the
appropriate box based on the following scale:
3 (A) Agree
A. Personal Condition SA MA A D SD
1. Feeling sleepy in class
2. Feeling hungry in class
3. Difficulty in seeing
4. Difficulty in hearing
5. Difficulty in breathing
B. Study Habits SA MA A D SD
1. I study only when there is a quiz
2. I feel tired, bored and sleepy
3. I prefer listening to radio, watching TV, etc.
4. I am lazy to study
5. I am disturbed when studying
6. I have no time to study at home
7. I study only when I like
8. I don’t have a comfortable place to study
9. I copy the assignments of friends
C. Home-Related Factors SA MA A D SD
1. I live far from school
2. I live near the school
3. I don’t live with my parents
4. Both my parents are working
5. I do too much households
6. I have many brothers and sisters
D. School-Related Factors SA MA A D SD
1. The time schedule is followed
2. There are school programs
3. There are available library references
4. Classroom is comfortable enough
5. There is fast internet access in the library
6. There is enough space in the library
7. Locations of classrooms
E. Teacher-Related Factors SA MA A D SD
1. Teacher has mastery of the subject matter
2. Teacher discuss many topic in a short period of time
3. Teacher uses audio/visual aids
4. Teacher gives too much memory work
5. Teacher provides varied activities
6. Teacher uses lecture method only
7. Teacher always scolds students
8. Teacher is frequently out/absent from class
9. Teacher is always late