Personal Information

Name: _____________________________ Gender: ___ Age: ____

Educational Background:__________________________________
Family: ________________

4 (ALWAYS) 3 (VERY OFTEN) 2 (SOMETIMES) 1 (RARELY)

Motivational 4 3 2 1

1. Getting a good grade is the most satisfying thing for me.

2. The most important thing for me is to improve my overall grade point average, so my
concern is getting a good grade.
3. If I study in appropriate ways, then I'll be able to learn the material.

4. I'm confident I can learn the basic concepts that are being taught.

5. Considering the difficulty of the classes, the teachers, and my skills, I think I can do well.

6. I prefer material that really challenges me, so I can learn new things.

7. The most satisfying thing for me is trying to understand the content as thoroughly as
possible.

8. I like the subject matter of this course.

9. Understanding the subject matter of this course is very important to me.

10. I feel like I can freely communicate with other students in classes Motivational

Goals 4 3 2 1

1. I feel Sense of belonging in every were I go.

2. I have Fun and enjoyment in taking my path I choose.

3. I feel Warm relationships with others

4. I always feel Self-fulfilment

5. I am being well respected in others.

6. Every time I pursue my dreams theirs always Excitement

7. I feel A sense of accomplishment every time a have one step apart in my dreams.

8. I feel Security every time I think of my dreams

9. I always have Self-respect.

10. I feel like effective when I help others.

Behaviour 4 3 2 1

1. How often do you feel lonely?

2. How often do you feel depressed?

3. How often do you procrastinate about that status of your personal goals in life?

4. Does your behaviour stop you when your peers are attending to other class?

5. Does your problem behaviour occur during specific celebration or activities?

6. Does your problem behaviour occur to get someone attention?

7. Did you experience problem behaviour more likely to continue to occur throughout
the day?
8. Did you experience bullying when it comes to your behaviour?

9. Did you always ignore your behaviour?

10. How often do show your true behaviour?