SCIENCE ANXIETY QUESTIONNAIRE

Name (Optional): Hymar Vann Tumimbang

Grade Level: 11 - Uranus Sex: _____Male ____Female
School & School Address: Dauin Science High School
General Instruction: The statements in this questionnaire are about science and science related
experiences. For each statement, place an X on the space under the column that best describes how you feel
in that situation.
Example:
Very Calm Fairly Neutral A little Very
Calm Nervous Nervous
Giving an oral book report X
(If giving an oral book report makes you nervous only a little amount, you would place an X on “A Little
Nervous”.)
Very Calm Fairly Neutral A little Very
Calm Nervous Nervous
5 4 3 2 1
1. Starting a science class
2. Having someone watch you do
an experiment
3. Studying for a test in science.
4. Planning a well-balanced meal to
pack for lunch.
5. Looking through the science
book for your class.
6. Mixing boiling water and ice to
get water to reach the right
temperature for an experiment.
7. Studying for a test about the
earth;
8. Visiting a science museum.
9. Being asked to explain a topic in
science class;
10. Using a thermometer. to
measure the temperature of
water in an experiment;
11. Taking a science test;
12. Measuring a cup of sugar to
make cookies.
13. Being called on in science
class;
14. Showing a classmate the results
of your experiment.
15. Taking a quiz in science.
16. Cooling down a hot sink of
water to the right temperature
to be able to wash dishes.
17. Asking the teacher a question
in science class.
18. Weighing something to use in
an experiment.
19. Memorizing the names of parts
of the body for a science test.
20. Lighting a grill for a barbeque.
21. Doing a science homework
assignment;
22. Figuring out how to connect a
light bulb in an electrical
experiment.
23. Memorizing the names of
things in space for a science
test.
24. Following the steps to build a
Model.
25. Listening to the to a teacher in
science class.
26. Adding a small amount of
powder to a liquid in an
experiment.
27. Showing your parents your last
science test.
28. Reading a science magazine
and having a friend ask you
about it.
29. Writing a report for science
class.
30. Following directions to do an
experiment.
31. Showing your parents your;
science grade on your report
card.
32. Focusing a camera to take a
picture of some friends.
33. Having a classmate listen to
your science report.
34. Focusing the lens of a
microscope.
35. Thinking about a test in science
one day before you are to take
it
36. Replacing a dead bulb in a
lamp.
37. Reading a chapter in your
science book and being asked
to explain it.
38. Blowing up a balloon to the
right size for a science
experiment on air.
 39. Thinking about a science test
one hour before you are to take
it.
40. Filling your bicycle tire with
the right amount of air

*Adapted from the work of Czerniak & Chiarelott (1984), “Science Anxiety: An Investigation of Science
Achievement, Sex and Grade Level Factors”.
SURVERY QUESTIONNAIRE ON STUDENT ANXIETY LEVEL TOWARDS LEARNING OF
SCIENCE SUBJECT AMONG SENIOR HIGH SCHOOL STUDENTS
Respondent Number:

This research is entitled “STUDENT ANXIETY LEVEL TOWARDS LEARNING OF

SCIENCE SUBJECT AMONG SENIOR HIGH SCHOOL STUDENTS ”. This particular research
study seeks to find out the extent of students’ anxiety towards learning science, influencing factors
towards science anxiety, might as well finding correlations between variables being considered in
this study. This survey questionnaire will help the researchers’ find answers to their research
questions.
Direction: Read and understand the questions carefully. Please put a check mark (√) on the bracket
provided by each questions below to the answer of your choice. Answer the questions honestly and
rightfully. Information that you will supply will be treated with the greatest confidentiality.
PART I: SOCIOECONOMIC STATUS [ ✓ ] Academic
1. Age [ ] Technical/Vocational/Livelihood
[ ] 15 years old & below [ ] Sports
[ ] Arts and Design
[ ✓ ] 16 years old
[ ] 17 years old
Your strand: ____________________
[ ] 18 years old
[ ] 19 years old & above
6. Performance in Science subject
2. Sex [ ✓ ] 90 above (Oustanding)
[ ] 85-89 (Very Satisfactory)
[ ✓ ] Male [ ] 80-84 (Satisfactory)
[ ] Female [ ] 75-79 (Fairly Satisfactorily)
[ ] 74 below (Did Not Meet Expectation) PART
3. Location II: FACTORS AFFECTING ANXIETY

[ ] Urban Directions: Below are the listed possible factors

which contributes to anxiety. Select only the
[ ✓ ] Suburban
factor/s which highly contributes to your science
[ ] Rural
anxiety. You may check one or more choices below.
If you have other answers not listed below, you may
4. Current Grade Level enrolled write them down under “Others”.

[ ✓ ] Grade 11 COGNITIVE FACTORS

[ ] Grade 12 ______ Classroom activities (experiments, lab
works) & lecture/discussion
5. Track & Strand __✓____ Tests/Examination administration
______ Peer/classmates pressure
__✓____ Lack of interest/motivation
towards subject
___✓___ Little or no knowledge about
science and science-related terms

EMOTIONAL/BEHAVIORAL FACTORS
___✓___ Doesn’t like the topics/content in
science
______ Trauma from past experiences
______ Perception that science is difficult
______ Teacher attitude or way of teaching
___✓___ Parent attitude/expectation
towards their student

BIOLOGICAL FACTORS
______ Health problems/issues
______ Genetics (anxiety present in your
bloodline)

SOCIOECONOMIC FACTORS
__✓____ Family problems
______ Socio-economic background
______ Home & school location

Others (Pls. specify)

___________________________________
______
___________________________________
______
___________________________________
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