PRACTICAL RESEARCH- SURVEY

PRACTICAL RESEARCH- SURVEY

NAME: _______________________________
NAME:
GRADE LEVEL: _______________________
GRADE LEVEL:
Instruction: Check the choice that best corresponds
Instruction: Check the choice that best to your answer.
corresponds to your answer.
1. Do you have trouble in going to school
1. Do you have trouble in going to early?
school early? ___ Yes ____ No
___ Yes ____ No
2. Were you often late to school?
2. Were you often late to school? ____ Yes ____ No
____ Yes ____ No
3. Do you miss your first period
3. Do you miss your first period lessons/quizzes when you are late?
lessons/quizzes when you are late? ____ Yes ____ No
____ Yes ____ No
4. Have you been late to school intentionally?
4. Have you been late to school ____ Yes _____ No
intentionally?
____ Yes _____ No *If Yes, Why?
___________________________________
*If Yes, Why? __________________________________
_____________________________
_____________________________ 5. Were you late mostly because of:
5. Were you late mostly because of: ____ Traffic
____ You live far
____ Traffic ____ You slept and woke up late
____ You live far ____ Homework/ Projects
____ You slept and woke up late ____ School starts at 7:15 am
____ Homework/ Projects ____ The Teacher was often late
____ School starts at 7:15 am ____ Peer Influence
____ The Teacher was often late ____ Household activities
____ Peer Influence ____ You work at night
____ Household activities
____ You work at night Other reasons: _________________
Other reasons: _________________ 6. Does being late affect your performance in
class?
6. Does being late affect your _____ Yes ______ No
performance in class?
_____ Yes ______ No *If Yes, How?
____________________________________
*If Yes, How? ___________________________________
_____________________________
_____________________________