QUESTIONNAIRE

COFFEE CONSUMPTION AND KMK STUDENTS STUDY HABIT

PART A GENDER : MALE ( ) FEMALE ( )

RACE :

MALAY OTHERS

( (

) )

INDIAN CHINESE

( (

) )

PST :

MODULE 1 MODULE 3

( (

) )

MODULE 2

PART B Purpose: To study the relationship between coffee consumption and KMK students study habits. Direction: Please put tick () on the point that corresponds to what you are actually doing, thinking, and feeling regarding the statement. There are no right and wrong answers to this questionnaire. Rest assured that your answers will be treated in strictest and will be used only for this study. 1. Do you drink coffee? Yes ( ),if yes please proceed to question 2. No ( ),if no please proceed to question 8. Do you drink coffee while you study? Yes ( ) No ( ) How often do you drink coffee per day? 1 cup ( ) 2 cups ( ) More than 2 cups ( ) When do you drink coffee? Before study ( ) During study ( ) After study ( ) How many cups of coffee do you consume per study session? 1 cup ( ) 2 cups ( ) More than 2 cups ( )

2.

3.

4.

5.

6.

Do you drink more coffee to study for a test? Yes ( ) No ( ) Does coffee help you to concentrate in you study session? Yes ( ) No ( ) Do you take other consumption besides coffee? Yes ( ), if yes please state : _______________________________ No ( ) Do you feel asleep during your study session without coffee? Yes No ( ( ) )

7.

8.

9.

10. Do you think coffee will affect your study? Yes ( ) No ( )