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Department of Education

Region VI – Western Visayas


Division of Roxas City
DUMOLOG NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL
Roxas City

INFORMED CONSENT FORM

Dear Participant:

We are the Grade 11 students of (Write your school name) who are currently doing a
research on (State your topic). The study is a major requirement for Practical Research 1
subject. In this regard, we would like to solicit your permission to interview you to learn
more about (Write the information that you seek from the participant).

If you choose to participate in this study, we will schedule a time to meet with you at your
most convenient time. During this time we would like to ask questions concerning (Write
the general objective of conducting the interview). This interview will take approximately
(Write the time duration). With your permission, we would like to audiotape the interview
in order to focus on the conversation. Only the group will have access to the tape. The
recordings will be transcribed and we will remove any identifiers during the transcription.
The tape will then be erased and your identity will be kept confidential and will not be
revealed in the final manuscript.

We will contact you again (through your secretary if there’s any) in a few days to clarify
and answer any questions you may have about this project and possibly schedule an
interview.

Please do not hesitate to contact us if you have any questions: (Your contact number)

We are thanking you in advance for your consideration to participate in this study.

Respectfully yours,
(Your name/s)
Researchers

Noted by:
(Your Teacher‘s Name)
Practical Research I Teacher

I agree to participate in this study.

Signature of Participant: __________________________ Date: ___________________


Department of Education
Region VI – Western Visayas
Division of Roxas City
DUMOLOG NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL
Roxas City

INTERVIEW PROTOCOL

Background Information on Interviewee:


Date: ________________________ Monthly Family Income: __________
Location: _____________________ Family Size (No. of Family Member)______
Name: _______________________ General Average: ________
(Gr. 12, 1st Sem.)

Introduction:
Good Morning participant. We are Tricia Aguilar, Antonio Bugtong, Ella Abo-ol,
Jerilyn Alcones, Jhon Cleoh Diasa, Nikka Mae Alcones and Kyle Angelo Delfin. We are
presently conducting a research about “The Survival Techniques of the Senior High School
Students towards the K-12 Curriculum.” The objective of the study is to discover the
survival techniques of the Dumolog Senior High School students toward the K-12
Curriculum of DepEd.

Opening Questions:
Tell me something about yourself?
(Istoryahi ko/kami parti simo kaugalingon?) (Ask follow-up questions)
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Context Questions:
1. How’s your studies?
(Kamusta man imo pag-eskwela?)
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2. Can you tell something about your experience as a pioneer of SHS program?
(Pwede mo mastorya imo mga naagyan bilang isa ka pinakauna nga magraduate
sang SHS nga programa?)
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__________________________________________________________________
3. Have you experienced any difficulty in SHS? Can you describe these difficulties?
(Naka-agi ka bla mga kabudlayan sa SHS? Pwede mo maistorya ini nga
kabudlayan?)
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__________________________________________________________________
4. Do you have complete and passing grades in all subjects you have taken?
(Nakompleto mo bala kag pasar ka sa mga subject nga imo nakuha?)
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5. Were you able to comply all your subject requirements?
(Nahatag ukon napasa mo bala ang mga ulubrahun sa imo mga subject?)
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6. Do you have any difficulty with regards to the examination? Why? If you have
difficulty can you describe it?
(May ara ka bala kabudlayan labi na gid sa test okun sa eksaminasyon?)
Ngaman? Kun may ara, pwede mo masaysay?
__________________________________________________________________
__________________________________________________________________
7. Do you have any difficulty with regards to performance tasks and activities?
Why? If you have difficulty, can you describe it?
(Nabudlayan ka bala sa mga ulubrahun kag mga aktibidades nga gina hatag?
Ngaman? Kun may ara, pwede mo masaysay?)
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8. Are you financially struggling? If no, why? If yes, how often and why?
(May problema ka bala sa kwarta? Kung wala, ngaman? Kung oo, masami bala
kag ngaman?)
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9. When are you given an allowance? On daily, weekly, or monthly basis? Why?
(San-o ka ginahatagan kwarta ukon balon? Kada -adlaw, kada-semana ukon
kada-bulan?) Ngaman?
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10. Do you have enough allowance to support all your expenses? Why?
(May ara ka bala ikasarang nga kwarta para masuportahan tanan nga
galastusan? Ngaman?)
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11. Were you able to survived the difficulties you have experienced in:
(Imo man bala nasulbar ang mga kabudlayan na imo naagyan: )
a. In your academics? How? or what did you do? Can you cite situations?
Sa imo akademiko? Paano? Ano imo gin ubra para ini masulbar? Pwede
ka bala kahatag mga sitwasyon?
____________________________________________________________
____________________________________________________________

b. In terms of financial? How? Or what did you do? Can you cite situations?
Sa kwarta ? Paano? Ano imo gin ubra para ini masulbar? Pwede ka bala
kahatag mga sitwasyon?)
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12. Were there difficulties that until now you have not yet solved? What are these?
and why?
(May kabudlay ka pa bala ayhan gihapon nga wala pa nasulbar o nahatagan
sulosyon? Ano ang mga ini? Kag ngaman? )
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13. What is/are the most effective technique/s you have observed and followed to
survive those difficulties?
(Ano ang mga pinaka-epektibo nga pamaagi nga imo ginsunod kag gin ubra para
masulbar mo ini nga mga kabudlayan?)
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14. Were there difficulties that until now you are still on the process of solving it?
What are these and why?
(Ano nga mga kabudlayan ang asta subong ara ka pa sa proseso sa
pagsulbar?Ano ang mga ini? Ngaman?)
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__________________________________________________________________
15. What important insights do you have with all the difficulties you have
experienced?
(Ano nga mga importante nga natun-an mo sa kabuhi kag pageskwela matapos
mo nga maagyan ini nga mga kabudlayan?)
__________________________________________________________________
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Closing Instructions:
Thank you very much for your genuine time. We would like you to know that we
were the only individuals who will have access to this audio material and after the research,
the content will be erased. If you wish to have a copy of the abstract of this research, we
would be very willing to send you one. Do you have any questions?
Again, Thank you very much!