University of Perpetual Help System Laguna - JONELTA

Basic Education Department – Senior High School

CONSENT FORM

I have read and understood the information presented in the invitation letter of THE

RESEARCHERS.

I am aware that it is within my discretion that the survey questionnaire which may be

included, in part or in whole, in the thesis manuscript without my name being specified for

confidentiality reason.

I am also cognizant that there are no known risks related to the study and that I may

voluntarily withdraw from the study at any time I wish to decline by advising the researchers.

With full knowledge of the foregoing, I agree, with my own free will and by signing my

name, to participate in this study.

Name of the Respondent :

Signature :

Date :

Name of Parent/Guardian:

Signature :

Date :