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A. PERSONAL BACKGROUND
1. State your full name, date and place of birth, as well as that of your spouse.
11. Do you communicate with members of your family of origin on a regular basis?
14. Were there unusual burdens or problems faced by your family when you were
growing up?
We are just a poor family.
18. Was there a particular experience that had a great impact on you?
26. What was your attitude towards people of the opposite sex?
40. How did you relate to your parents, to your brothers, and to your sisters?
41. What was the manner by which your parents disciplined you?
47. How old are you when you first attended school?
7 yeaers
55. When and how did you and the respondent meet?
So first I met his father on board a bus going to Lemery. He talked to me and asked
me if I have a boyfriend and I said that I don’t have. He asked me where I study and
we found out that his son and I both studies in PMI. He expresses his intention to be
the girlfriend of his son because I am beautiful.
Dennis, my neighbor and friend also introduced Edsel to me. When I I first met him I
was shocked.
64. At that stage, were there indications that the relationship would fail?
66. Did your life change in any significant way during your boyfriend-girlfriend
relationship?
67. Were there significant events during this time?
71. Were you able to make a sensible, mature, & informed decision to marry?
72. What were the feelings of your respective families about the marriage?
81. Was there any physical or emotional distress resulting from the wedding and
honeymoon?
86. What efforts did each one of you exert to make the marriage work?
87. Who was the dominant spouse & how did the other react?
91. What were the major disagreements and tensions in your marriage? Discuss fully.
96. Was there any moral or character problems like lying, stealing, arrest, imprisonment
or trouble with authorities?
102. Is the respondent providing financial support to you and your children?
104. Is it sufficient?
106. If so, please enumerate and state the extent of your contribution thereto.
108. Did either of you fulfill your sexual obligations to the other?
109. Was there an unreasonable demand for sex?
121. What impact did respondent’s unfaithfulness have with you and your marriage?
125. Who was more responsible in their upbringing, moral guidance, and material needs?
Both of us,
128. Did either of you abuse the children physically, emotionally or verbally?
133. How much effort did each of you exert towards reconciliation?
135. What was the exact date when you ceased living together under one roof?
June 2014 to 2019
136. What brought about this final separation?
137. From your point of view, explain why your marriage failed.
Nagfailed yung marriage naming, yung ex boyfriend.
141. Feel free to volunteer additional information not covered by this questionnaire.