SURVEY QUESTIONNAIRE

To the respondents:
The undersigned is currently conducting a research study entitled “Social Skills and
Academic Performance of Grade 11 STEM -A senior high school students at West prime
Horizon Institute Inc. Pagadian city.
The purpose of this study is to investigate the relationship between social skills and
academic performance of grade 11 STEM students in a private school in Pagadian city.
Please accomplish this survey questionnaire by answering all questions as honest as
possible. Information gathered will be treated with utmost confidentiality and will be used for
academic purposes only. Thank you.

Sincerely yours,
SOCIAL SKILLS AND ACADEMIC PERFORMANCE OF GRADE 11 STEM (Group 1)

PART I. PROFILE OF THE RESPONDENTS (put a check ( ) and fill-up)

1. What is your gender? _______Male ______Female

2. How old are you? _______ years old

3. What grade are you now? ______

4. What is your strand? __________________________________________________

PART II. SOCIAL SKILLS QUESTIONNAIRE

Directions: The following statements are about your feelings and attitudes on your social skills.
Please choose the best answer and check.
4= Strongly agree 3= Agree 2= Disagree 1= Strongly disagree

SOCIAL SKILLS 4 3 2 1
1. When someone asks me a
question, I answer them.
 2. I can start a new conversation
with someone
3. I join in on conversations
with other people.
4. I change conversation topics
appropriately.
5. I speak clearly so others can
understand what I am saying.
6. When I am talking to
someone, I use appropriate
body language
7. I am able to stay out of other
people’s personal space.
8. When I am talking to
someone to me, I show them
that I am listening by looking
towards them and nodding
my head.
9. I use greetings (“Hi, how are
you?)
10. I used Farewells (“It was
good to see you. Bye!”)
11. I choose topics of
conversation that other people
would find interesting as
well.
12. When I am talking to
someone who I don’t know
well, I avoid such topics as
religion, sex, politics, and
personal information.
13. I use the telephone
appropriately to give and
obtain information.
14. Even when I get frustrated, I
am able to stay calm.
15. If I disagree with someone, I
still show them that I respect
their ideas.

PART III. ACADEMIC PERFORMANCE QUESTIONNAIRE

Below is the list of the ways you might or behaved during the activities. Please choose the best
answer and check the proper number.
4= Strongly agree 3= Agree 2= Disagree 1= Strongly disagree

ACADEMIC 4 3 2 1
PERFORMANCE
1 I’ am very
disappointed with
my academic
grades
2
3
4
5
6 I am distracted in
classroom
7 During the lessons,
I intervene to
express my
opinions
8 My school is a
place where I feel
alone
9 I am absent in
school without
valid reason
10 I deliberately
disturb classes
11 I am distracted in
the classroom
12 My school is a
place where I feel
integrated
13 Coming to class
early
I feel that there is
too much work
I feel there is too
much homework.
I Usually cannot
sleep because of
my worry to fail
the goals set
myself
 My parents care
about my school
engagement too
much, brings me a
lot of pressure.
I feel a lot of
pressure of
studying
I feel there are too
many tests in the
school

What are the most interesting activities that memorable for you this semester?
______________________________________________________________________________
______________________________________________________________________________

Thank you very much!