Republic Central Colleges

College of Arts, Sciences and Education

Name (optional):
Gender:

Direction: Put a check () on the boxes provided with your corresponding answers.
1- Never
2- Rarely
3- Sometimes
4- Very Often
5- Always

I am absent because.. 1 2 3 4 5
A. Physical Factor
1. our house is too far from the school.
2. it is unsafe in our place that restricts me to go
to school safely.
3. nobody accompanies me in going to school
since our house is far.
B. Health
1. I have a toothache.
2. my stomach hurts.
3. I have a headache
4. I'm down with fever/flu or diseases like
diarrhea, etc.
B. Personal Attitude
1. I am not interested in my studies.
2. my friends influence me to be absent from my
classes.
3. I do not wake up early.
4. I do not study/make my assignments before the
class start.
5. I am fond of playing computer games.
D. Classroom atmosphere
1. our classroom is hot and uncomfortable.
2. it's noisy inside our classroom.
3. A classmate/classmates bully me.
4. My friends influence me to be absent from my
class
5. I have no friends in our class.
E. Home-Related
1. My parents tell me to be absent from class.
2. My parents quarreled.
3. My parents don't care about my studies.
4. I'm too pre-occupied with household chores.
5. I have no money to buy snacks in school.
6. I did not eat my meal before the class.
7. I can't concentrate with my studies due to my
family problems.