Republic of the Philippines

Moonwalk National High School

Moonwalk, Paranaque City
Department of Education

Dear Validators,
Greetings!

We, Researchers of 12-Caesium, undergo with our Research entitled:

Impact of Remote Learning on the Academic Performance among Selected Grade 11 GAS
Students in Moonwalk National High School S.Y. 2021-2022. 
        
        With your expertise, we request your permission to validate our self-made questionnaire to
qualify for conduction.
     
        We are looking forward to our request merits your positive response. Your positive
response is highly appreciated.

              Thank you, and God bless.

Truly Yours,

Jeremy O. Bonete Junas Miguel U. Rama Jerelen D. Montes Ymel Gabriel M. Mijares

Cedric G. Bernardo Ailieneth C. Reyes Exzekiel D. Correa James Leannard C. Navaja

Tejay S. Intendencia Ronabel B. Romero Jerell Janell C. Beldia Aldrix D. Verano

Researchers

Noted by:
Ms. Abigail Christine Estoesta Palisoc LPT, MA-ESL
Adviser
 Republic of the Philippines
Moonwalk National High School
Moonwalk, Paranaque City
Department of Education

Dear Respondents,
Greetings!

We, Researchers of 12-Caesium, are surveying line with the study entitled: Impact of
Remote Learning on Academic Performance among Selected Grade 11 GAS Students on
Moonwalk National High School S.Y. 2021-2022.
        
We want your cooperation by answering the questionnaire honestly and completely. Any
information you provide shall be highly appreciated, and we assure you that all data will be
treated with the utmost confidentiality.
                          
              Thank you, and God bless.  

Truly Yours,

Jeremy O. Bonete Junas Miguel U. Rama Jerelen D. Montes Ymel Gabriel M. Mijares

Cedric G. Bernardo Ailieneth C. Reyes Exzekiel D. Correa James Leannard C. Navaja

Tejay S. Intendencia Ronabel B. Romero Jerell Janell C. Beldia Aldrix D. Verano

Researchers

Noted by:
Ms. Abigail Christine Estoesta Palisoc LPT, MA-ESL
Adviser
 SURVEY QUESTIONNAIRE

Please accomplish this questionnaire by putting a check mark (✓) on the box provided by each
number. Kindly do not leave any items unanswered.

Part I: Respondent’s Profile

Name: (Optional) ________________________________________________________________

Last Name, First Name, M.I.

Sex: ( ) Male ( ) Female

Section:
( ) Copper
( ) Nickel
( ) Zinc

Part II: Questionnaire

Direction: Please rate the statements by checking (✓) the appropriate rating box. Use the following
scale.

Option Verbal Interpretation

1 Strongly Agree
2 Agree
3 Disagree
4 Strong Disagree

Distraction 1 2 3 4
1. I finish my homework first before I do my house
chores.
2. I limit myself to using social media.
3. Before I talked with my friends, I finished my
activities first.
4. I avoid watching television during weekdays or
when I have an online class.
5. I estimate my time using other apps to avoid
unnecessary stress and distraction during remote
learning.
Time Management
1. My time management skills improved when the
remote learning started.
2. I learned new coping mechanisms to study from
remote learning.
3. I am less likely to make some of my habits from
Face-to-face today at remote learning.
4. I spend more time studying in remote learning
than in face-to-face classes.
5. I had difficulty studying alone or 'self-learning'
during remote learning.

My Benefits 1 2 3 4
1. I spend 3-5 hours on average each day on distance
learning.
2. A laptop, desktop, smartphone, or tablet is an
advantage when it comes in distance learning.
3. Having a strong internet connection makes it easy to
access schoolwork.
 4. I create a daily schedule before I start my activities.
5.  I can control my time. I either attend my online
class or watch the video my subject teacher has
recorded.

Validated by:

________________________ _________________________
_________________________
Name & Signature Name & Signature Name & Signature