Age: Course:

Grade/Section:

I. This survey aims to find out students’ extracurricular activities status. Thankyou for your time and
cooperation.

Direction: Kindly put a check on the columns provided that applies on your answer.

Behavior Very Very

Little Much

1 2 3 4 5

Does it help you make

friends?

Do you gain experience in

being in a sports club?

Does it help you tighten

your bond with your
friends?

Does it help you build your

leadership skills?

Does it help you build your

relationship with your
friends and club mates?

Contribution
Does it help you build your
confidence?

Does it help you for what

you are now?

Does it help you build your

self-esteem?

Does it help you be a good

citizen?
Does it help you build
positive peer relations?

Mental Health
Does it help you control
your emotions?

Does it help you control

your self-discipline?

Does it help you solve

problems easily?

Does it help you build your

concentraition?

Does it help you build your

sense of initiative?

Behavior
Does it affect your
relationship with your
family?

Does it affect the way you

treat your relatives?

Did you lost interest in

school works?
Do you still have time to go
out with your family?

Does it affect your

lifestyle?

Contribution
Does it affect your
performance in school?

Do you still have time to

make school works? (such
as Home works, projects,
etc.)
Did it affect your interest in
studying?