Date: January 24, 2019 Subject: Permission to Conduct

Research To: Nadine Abellera, MA Cand

Add.: Xavier University – Ateneo de Cagayan
9000 Cagayan de Oro City

Dear Sir:

We are Gemwel Mariel Jumalon, Charyll Brigette Jauculan, Jether Jame Lamparas, and
Samantha Ruth Anne Velasco. We are college freshmen students who are currently taking up Bachelor of
Science in Psychology at Xavier University- Ateneo de Cagayan, in Cagayan de Oro City, Misamis Oriental. In
compliance for our Psychology 3 subject, we are currently writing a mini research paper and we are writing to
you to ask for your permission to allow us to gathering data from your classes. We are currently making a
research about the “The Parent-Adolescent Relationship and Teacher-Student Relationship and its Influence
on the Adolescent’s Socializing Skills”. This study aims to determine the influence of the Parent-Adolescent
Relationship and the Teacher-Student Relationship towards the Adolescent’s Socializing Skills.

We are hoping to gather information from 230 participants who are currently enrolled in Bachelor
of Science in Psychology and Bachelor of Arts in Psychology. Each of the participants will be given an
informed consent form. After processing the informed consent form, the participants will be given a
demographic profile and a three part questionnaire. The first part of the questionnaire is the Parent-Adult Child
Relationship Questionnaire (PACQ). It is a 26 item questionnaire that will assess the relationship of the child
towards their mother and father with factors of regard, responsibility and control. The second part of the
questionnaire is the Student- Instructor Relationship Scale (SIRS). It is a 36 item questionnaire that assesses
the relationship of the students towards their instructor with factors of connectedness and anxiety. The third
part of the questionnaire will be the Small Group Socialization Scale. It is a 14 item questionnaire that
assesses the socialization level of students to their social groups.

The total survey process will not take longer than 30 minutes, the survey results pooled for the
mini research paper and the individual results will be kept confidential and anonymous. Only the pooled
results will be documented if this study will be published. Our research instructor will also be given a copy of
the results of the study. No cost will be incurred to your department and the participants involved in our study.
Each of the participants will also be given a simple token as our sign of gratitude for their participation in our
study.

Your approval that we can have our survey during your classes will be highly appreciated and will
serve as help for Students to learn about the influence of their relationship to their parents and teachers
towards their socializing skills. You may contact our leader, Gemwel Mariel Jumalon at 0926-366-3072 for
inquiry and more information about our study. If you agree for us to conduct our study, kindly sign below and
return it to whoever from the group submitted this letter to you.

Thank you Maam!

Sincerely, Gemwel Jumalon Charyll Jauculan Jether Lamparas Samantha Velasco Researcher

– Group Leader
 Researcher Researcher Researcher

Noted: Reynan Sarsalejo Salo, MA

Instructor

Approved: _______________________________ ____________________ _____________

Name
Signature Date

** Attached herewith:
➢3 sets of questionnaires (PACQ, SIRS and Small Group Socializing Scale)
➢Informed consent form