Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
Gate 2 Karangalan Village
1900 Cainta, Rizal

Questionnaire for the Evaluation of Self-learning Module for Grade 11

Learning Area: ____________

I. Personal Data
Name: (Optional) Age:
School: Sex:

II. Evaluation Instrument

Directions: Put a check mark (/) on the column that corresponds to the degree of your agreement/
disagreement to the statements in the table. Please feel free to give your comments and
suggestions for the improvement of the instructional module.

RESPONSE
STATEMENTS Strongly Agree Disagree Strongly
Agree Disagree
(4) (3) (2) (1)
Objective
1. I understand the objective in the self-learning
module clearly.
Content
1. The ideas in the self-learning module are
interesting and useful to me.
2. The self-learning module considers my attitudes
and feelings.
3. The self-learning module teaches me good values.
4. The self-learning module helps me to understand
the lesson and enables me to apply what I have
learned in my daily life.
5. The lesson presented in the self-learning module
interrelates well with what is being taught by my
teacher.
6. The self-learning module respects my gender,
religion, culture and beliefs.
7. The self-learning module showcases my culture
and community.
8. The words used in the self-learning module are
easy to understand.
9. The self-learning module gives concrete examples
for me to easily understand new ideas.
Methodology
1. The self-learning module presents variety of
activities that help me learn the lesson.
2. The self-learning module matches my learning
styles and expectations.
3. The self-learning module teaches me to be
 Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
Gate 2 Karangalan Village
1900 Cainta, Rizal

responsible with my own learning.

4. There are discussion questions which encourage
me to think creatively.
5. All the instructions in the self-learning module are
clear.
Physical Layout and Organization
1. The cover, format, print size, and pictures are
appealing to me.
2. New ideas are linked to my prior knowledge and
past experiences.
3. Presentation is engaging, interesting, and
understandable.
4. There is logical and smooth flow of ideas.
5. Vocabulary level is adapted to my experience and
level of understanding.
6. Length of sentences is suited to my
comprehension level.
7. The questions are clearly worded.
8. Sentences and paragraph structures are varied and
interesting to me.

Comment/s:
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Suggestion/s:
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Thank you very much!