Direction: Fill in the blanks.

Name : _________________________________________________________ Weight : ___________

Check the box.

Daily Allowance: below P50 Gender: M F

P51 – P100

P101 – P120

P120 above

Direction: Read each statement and put a check ( / ) under the column that applies to you.
Your answer will remain strictly confidential so please answer HONESTLY.

Always Often Seldom Never

1.) I do stress eating whenever I experience

stress.

2.) I eat to relieve stress.

3.) I eat a lot during exams.

4.) I ate whenever I got low score.

5.) I eat so that I can forget about the stress in

school for a while.

6.) I do not eat properly when I need to study.

7.) I prioritize my school works more than eating.

8.) I do not eat properly when I experience stress.

9.) I forgot to eat on time when I am doing my

school works.
10.) I lose my appetite when I have a lot of school
works to finish on time.

11.) I stress myself when I’m having difficulties

finishing my school works.

12.) I do my school task in advance to avoid

procrastination.

13.) I experience stress when studying for

quizzes and exams.

14.) I eat junk foods when I review.

15.) I spend most of my allowance on school-

related materials.

16.) I use my daily allowance to buy snacks.

17.) I spend most of my allowance on food trips.

18.) I am fond of buying foods from most of my

allowance.

19.) I budget my allowance to spend for foods

and school supplies.

20.) I save my allowance to buy school projects if

needed.