DEPARTMENT OF EDUCATION

Republic of the Philippines

Region 1
Schools Division of Ilocos Sur
TEODORO HERNAEZ NATIONAL HIGH SCHOOL
Sabuanan, Sta. Lucia, Ilocos Sur

Study Title: Impacts of Modular Distance Learning to the Academic

Performances of Grade-12 STEM CY 2020-2021

Part I. Profile of the Student-respondents

Directions: Please review and response to each questions on this form with all
honesty. Upon completion, please return this form to the researchers. Rest assured
of your identity’s confidentially. Thank you!

1. Name (Optional): _______________________________________

2. Age : ___________
3. Gender: ___ Female ___ Male
4. Location/Address:
5. Near the School
Nearby Barangays
Near Mountainous Areas
6. Studying Hours:
1-2 hours 7-8 hours
3-4 hours 9 and above
5-6 hours
Part II.

Directions: Please put a check (√) mark on the space provided if you strongly
agree, agree, disagree, strongly disagree, or if you feel neutral about the following.
Base your answer to the rating given below.

5 - Strongly Agree 2 - Disagree

4 - Agree 1 - Strongly Disagree

3 - Neutral

5 4 3 2
1. I don’t need to waste time in transport such as waiting for
a bus or tricycle.
2. I can find the convenient time to study.

3. I should have a strong motivation in maintaining the right

pace of learning.
4. I can easily grasp the contents of module rather than
those in the books.
5. I can learn at my own pace.

6. I can study whenever I want.

7. I can be more active in the face-to-face environment.

8. I cannot access the necessary facilities such computer

and Internet to help my study.
9. I am highly distracted because of no face-to-face
interaction.
10. I have limited interaction with my teacher which makes it
harder to study my lessons.
11. I can create my own schedule in doing my modules.

12. I find it harder to find my own pace of studying with

modular learning.
13. I am easily tempted to do other things rather than
finishing my module.
14. I developed a sense of self-responsibility in finishing my
module.
15. I can create my own learning style that can help me
learn more effective.