Sample Questionnaire Essay Example for Free

Sample Questionnaire Es submitThe purpose of this survey is to determine to what consequence the different factors in carriage do and study inte equaliser affects individual.Enclosed you in allow for find a self-addressed, stamped envelope to use when returning(a) the survey. enjoy feel free to include any additional comments you deem necessary or pertinent to improving the behavioral aspect of individual. Be assured that all your answers ar highly confidential and will be treated with privacy. Your chemical reaction and time is greatly appreciated. Thank youSincerely,Floriden DairoCamille PunzalanMarilyn Vargsabloody shame Grace RomeroJohn capital of Minnesota Bernaldez(BSE III-B, English)Below is a list of statements. Please indicate how you feel close to eachstatement by checking the box of your answer.How family background does affect your behavior and interest in study habits? 1. My parents really care for me(_) True(_) faux2. I get along well with my parents and siblings(_) True(_) False3. My parents really listen to I fork out to say(_) True(_) False4. My parents care whether I come at home very late at nighttime (_) True(_) False5. My parents didnt pay attention to what I have to say.(_) True(_) False6. My parents didnt appreciate my exploit(_) True(_) False7. My parents always fight(_) True(_) False8. My mother always nagged me especially if we do not have enough money (_) True(_) False9. My parents didnt support our studies(_) True(_) False10. My parents encouraged me to have an occupation at an early age (_) True(_) FalseHow do gadgets affect your attitude and interest in the study? support your answers.1. What gadgets do you have?(_)Cellular phone (_) IPod (_) Television (_) Radio (_) Digital Camera (_) others 2. Do you really essential to romp games, listen to music, etc. rather than studying your lesson? (_)Yes (_) No3. Whenever your mother does the household chores, do you serving her? (_)Yes (_) No4. At night, do you prefe r to listen in the radio, instead of taking a rest?(_) Yes (_) No5. Instead of playing outdoor activities, do you prefer to stay at home and play with your gadgets? (_) Yes (_) No6. Did your parents bought whatever you ask, like all your gadgets for you to be in with your armadas? (_)Yes (_) No7. Did radio, television, and other technologies sometimes wait on you to do your school activities? (_) Yes (_) No 8. Do you use your gadgets to degrade your classmates for not having it? (_)Yes (_) No9. Did you spend more than time with your gadgets rather than with your family? (_)Yes (_) No10. Did your parents allowed you to addict in all gadgets that may cause of losing your interest with your studies. (_)Yes (_) NoHow do peers and peer pressure affects your attitude and study interest? Do you prefer to do things separately?(_) Yes (_) NoDo you prefer to do things with the help of your friends?(_) Yes (_) NoDo your friends affect largely your decision-making?(_) Yes (_) NoDo you always decide based on your peers decisions?(_) Yes (_) NoDo you take your friends judgments before making friends to others? (_) Yes (_) NoI am conscious about what I will wear before my friends might tease me. (_) Yes (_) NoAre you afraid on ballyrag?(_) Yes (_) NoIf yes, do you have a feeling that if you neglect your friends judgments, they might ruffian you? (_) Yes (_) NoIf no, do you believe that if you dont do something wrong, nothing should be shame of? (_) Yes (_) NoDo you agree that self-progression is through your own hard work and perseverance? (_) Yes (_) NO1) How familiar are you with your schools mission statement for school unhurtty Very FamiliarSomewhat familiarNot overly familiarNot at all Familiar2) How familiar are you with your schools emergency response design? Very FamiliarSomewhat familiarNot excessively familiarNot at all FamiliarPlease tell us how much you agree or disagree with the following statements. 3) direct staff and governing uphold all disciplin e policies. strongly resist protestUndecided fitStrongly stand for4) The school provides adequate training for staff on school policies and procedures. Strongly DisagreeDisagreeUndecidedAgreeStrongly Agree5) Emergency response proposals are known by all teachers and administration. Strongly DisagreeDisagreeUndecidedAgreeStrongly Agree6) Emergency response drills are performed regularly by teachers and students. Strongly DisagreeDisagreeUndecidedAgreeStrongly Agree7) The school has an anonymous student hotline for reporting potential salutaryty problems, such as threats. Strongly DisagreeDisagreeUndecidedAgreeStrongly Agree8) The school takes all threats and rumors of violence seriously and investigates appropriately. Strongly DisagreeDisagreeUndecidedAgreeStrongly Agree8) All visitors to the school are hold and accounted for at all times. Strongly DisagreeDisagreeUndecidedAgreeStrongly AgreePlease tell us how satisfied or dissatisfied you are with the following 9) How satisfie d are you with the level of control the school maintains on all entrances and exits? Very snugslaked disgruntledVery disgruntledDont Know10) How satisfied are you with the exterior safety lighting? Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDont Know11) How satisfied are you with the interior safety lighting? Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDont Know12) How satisfied are you with the level of support the administration gives to teachers for dealing with discipline problems? Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDont Know13) Overall, how safe do you feel in your classroom?Very SafeSome what safeNot too safeNot at all SafeDont Know14) Overall, how safe do you feel foreign on the school grounds? Very SafeSome what safeNot too safeNot at all SafeDont Know15) Overall, how satisfied are you with your schools safety policies? Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDont Know16) Overall, how satisfied are you with your schools emerge ncy response plan? Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDont KnowPlease indicate the extent to which the following are problems for you.Always-3 Often 2 Sometimes -1 Never 0Cutting classesSaying crappy wordsBulliedSmokingFinancial problemAbsenteeismExcessive use of alcoholSleeping during the class ripe homeworkLatecomerCheatingFighting with others studentsUsing cell phones/iPods/electronics during class hour Being honest about all rulesPlease indicate the extent to which the following are the appropriate assessment for the behavioral victimization of the students. Strongly Agree-3 Agree-2 Disagree-1 strongly disagree-0Conducting seminars and ProgramsMaking organizations having counselingPunishmentsDismissal of the students from schoolDetentionReferencesDurand, V. M., Crimmins, D. B. (1992). Motivation assessment scale. Topeka, KS Monaco Associates Incorporated.Iwata, B. A., DeLeon, I. G. (1995). The operable analysis screening tool (FAST). Unpublished manuscri pt, University of Florida.Lewis, T.J., Scott, T., Sugai, G. (1994). The problem behavior questionnaire A teacher-based instrument to develop useful hypotheses of problem behavior in general education classrooms. Diagnostique, 19(2-3), 103-115.Mason, S. A. Egel, A. L. (1995). What does Amy like? Using a mini-reinforcer assessment to make up student single outicipation in instructional activities. Teaching Exceptional Children, 28, 42-45.ONeill, R. E., Horner, R. H., Albin, R. W., Storey, K., Sprague, J. R. (1997). Functional assessment and programme development A practical handbook. Pacific Grove, CA Brookes/Cole Publishing Company.Singh, N. N., Matson, J. L., Lancioni, G. E., Singh, A. N., Adkins, A. D., McKeegan, G. F., Brown, S. W. (2006). Questions about behavioral die hard in mental illness (QABF-MI). Behavior Modification, 30(6), 739-751.https//www.google.com.ph/search?q=sample+survey+questionnaire+about+family+backgroundtbm=ischtbo=usource=univsa=Xei=BWpdUp62E8fxiAfUiI GIDwved=0CGIQsAQbiw=1366bih=664facrc=_imgdii=_imgrc=bWprTi6c_vvXQM%3A%3B9lwusfzU6z3OBM%3Bhttp%253A%252F%252Fwww.uncssp.org%252Fimages%252Fsspsamplequestions_school11ak.gif%3Bhttp%253A%252F%252Fwww.uncssp.org%252Fabout_samplequestions.asp%3B300%3B392Questionnaire(SOCS II)Submitted byCamille PunzalanFloriden DairoMarilyn VargasMary Grace RomeroJohn Paul BernaldezSubmitted toMs. Mileth Caraan(SOCS 2 Teacher)GOODBYE By AnonymousI wish I hadnt met someone like you soul who is good to be true Someonewith charms of dreams, of fiction Someone youd be willing to pour out your affection Goodbye for me, I wont look back Your jokes so funny, youd make me crack Your laughter, your grimace, voice so sweet Your lips so red, your eyes so deep.To my questions you are the answer You are the bonfire in the cold day of overwinter You are the rain that makes flower bloom You are the light that comes from the moon. But goodbye for now, we must part Youll always occupy a place in my heart As I turn my back, hinder and be glad Rather than remember and be sad Just wipe your eyes and smile once more Hope youd find what youre looking for Goodbye my life, my strength, my love, A stage of fate from heavens above.