The effect of having Broken Family to the Academic Performance of Fourth year students of LICS S.

Y 2012-2013

Name: Year & Section: Direction: Answer the following questions. Right check in the box.

Age: Gender:

YES

NO

1. Are you one of that Broken Family? 2. If you are in Broken Family. Do you want to reconcile your parents? 3. Did the situation of Broken Family affect your grades or academic performance in school? 4. It is hard to have a Broken Family while you are studying? 5. Did the situation of Broken Family affect you habits in doing school works or going to school? 6. Did you have a thought of not going to school anymore? 7. Did you ever consult or share your problem to your teacher or guidance counselor? 8. Can you still study while living in a Broken Family? 9. Is it possible to overcome your problem on your own? 10. Did you ever think that you still need study than to be really affected the situation?