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a. age
b. sex
c. Course
d. Year Level
2. What are the effects of habitual liquor of drinking to the academic performance?
performance?
EASTERN QUEZON COLLEGE, INC.
March 4, 2019
Sir:
The undersigned is a 4th year college student, taking up Bachelor of Secondary Education
is currently conducting his undergraduate study entitled “THE EFFECTS OF
HABITUAL LIQUOR OF DRINKING TOWARDS THE ACADEMIC
PERFORMANCE OF SELECTED COLLEGE STUDENTS IN EASTERN
QUEZON COLLEGE DURING SCHOOL YEAR 2017-2018”.
In relation to this, may he request from your good office to administer his questionnaire
to some students in your institution this March 2019. Rest assured that the data to be
gathered shall be used with confidentiality and academic purpose only.
Thank you very much in anticipation of your favorable consideration on this request.
Noted by:
GIL T. SEGUI
Research Adviser
Approved by:
MARCH 4, 2019
Dear Respondents:
The undersigned is a fourth year BSED student and currently in the process of
doing her undergraduate thesis entitled “THE EFFECTS OF HABITUAL LIQUOR
OF DRINKING TOWARDS THE ACADEMIC PERFORMNCE OF SELECTED
COLLEGE STUDENTS IN EASTERN QUEZON COLLEGE YEAR 2017-2018
Sincerely yours,
Noted by:
GIL T. SEGUI
Research Adviser
EASTERN QUEZON COLLEGE, INC.
Questionnaire
Direction: Please put check mark (̷) on the space provided as carefully and as honestly as
possible.
A. AGE
_____ 36-Above
_____ 31-35
_____ 26-30
_____ 16-20
_____ 15-Below
B. SEX
_____ Male
_____ Female
C. COURSE
D. YEAR LEVEL
_____1st year
_____2nd year
_____3rd year
_____4th year
PART II-What are the effects of habitual liquor of drinking to the academic performance?
Direction: Please put check mark (/) to the appropriate column that best describes your
answer.
Indicators:
5. Difficulty concentrating
6. Memory trouble
7. Lowered inhibitions
9. Dependence on alcohol(alcoholism)
PART III- How do this habitual liquor of drinking affects to the academic
performance?
EASTERN QUEZON COLLEGE, INC.
Direction: Below are the indicators that describe the affects of liquor drinking towards
the academic performance. Please put check mark (/) on the appropriate column
corresponding to your answer.
Indicators:
B. Affect to Academic
Performance 5 4 3 2 1
1. Late in class
2. Difficultly to understand
the lesson
3. Failed result of quizzes
_______________________
(Signature of the Respondent)