The Slum Life of Kabibe: Sample Research Material Part I

Questionnaire No. ____

Respondent No. ____

Dear Respondent,

Good Day! We are Mark Anthony Cabanlit and Angeli Macopia, second year students taking up Communication II. We are conducting a study the effects of the number of hours of computer usage on the retention ability of UP Students. We would like to ask a little of your time to answer this questionnaire. Please answer it with all honesty. We assure you that this is confidential. We are hoping for your kind cooperation.

Thank you!

Sincerely Yours,

The Proponents

I. Personal Information

Name (Optional):

Age:

Course & Year:

STFAP Bracket: ______

II. Academic Capability

General Weighted Average(Second Sem-A.Y. 10-11): _____

Grades on the following major subjects:

CMSC 11: _____

CMSC 21: _____

III. Number of years since the first use of computer: ______

IV. General Instruction: Please write the time duration (HH:MM – HH:MM) from the time you started using your computer in a particular instance in any time of the day. Please write whether it is at Home or in School.

Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
8:19-8:50 ☀	8:07-8:50 ☀	1:35-1:50 ☀	8:35-8:50 ☀	8:10-8:50 ☀	8:35-8:50 ☀	1:35-1:50 ☀
10:55-8:59 ☀	8:35-8:50 ☀	3:57-4:50 ☀	8:35-8:50 ☀	8:35-8:50 ☀	10:55-8:59 ☀	3:57-4:50 ☀
11:25-11:05 ☀	1:35-1:58 ☾	9:35-9:50 ☀	1:35-1:58 ☾	1:35-1:58 ☾	11:25-11:05 ☀	9:35-9:50 ☀
8:35-8:50 ☾	2:15-2:40 ☾	5:36-5:50 ☾	2:15-2:40 ☾	2:15-2:40 ☾	8:35-8:50 ☾	5:36-5:50 ☾
10:35-10:50 ☾	9:35-9:50 ☾	10:12-10:50 ☾	9:35-9:50 ☾	9:35-9:50 ☾	10:35-10:50 ☾	10:12-10:50 ☾