Survey Questionnaire

Dear Student Respondents:

This survey questionnaire form is part of my on-going thesis entitled “ENGLISH
ANXIETY IN RELATION TO ACADEMIC PERFORMANCE OF GRADE 7 STUDENTS: BASIS
FOR INTERVENTION”. Kindly fill out the data being requested. Please be assured that
your responses will be kept confidential and will be used for the purposes of this study
only. Thank you for your participation.

FRANCE D. LLANERA
Researcher/M.A. Candidate
La Carlota City College
City of La Carlota

Name (optional):______________________________________

Part 1: PROFILE

Please put a check (/) mark in the box that corresponds to

your answer.

a. Sex
Male

Female

b. Family Monthly Income

 Class E (8,000 & below)
 Class D (8,001- 15,000)
 Class Broad C (15,001 and 30,000)
 Class Upper C (30,001- 50,000)
 Class B (50,001- 99,000)
 Class A (100,000 and Up)

c. Membership in Clubs/Organizations
 Supreme Student Government
 English Club
 Math Club
 Science Club
 Filipino Club
 None

d. ICT Facilities at Home

 Personal Computer
 Laptop
 Smartphone
  Tablet
 Television
 Radio

Part II. English Language Anxiety

5 Strongly Agree 4 Agree 3 Neither 2 Disagree 1 Strongly

Agree/Disagree Disagree

1. I never feel quite sure of myself when I am speaking in the English 1 2 3 4 5

class.
2. I don't worry about making mistakes in the English class 1 2 3 4 5
3. I tremble when I know that I'm going to be called on in the English 1 2 3 4 5
class.
4. It frightens me when I don't understand what the teacher is saying 1 2 3 4 5
in the English
class.
5. It wouldn't bother me at all to take more English classes. 1 2 3 4 5
6. During English class, I find myself thinking about things that have 1 2 3 4 5
nothing to do with
the course.
7. I keep thinking that the other students are better at languages than I 1 2 3 4 5
am.
8. I am usually at ease during tests in my English class. 1 2 3 4 5
9. I start to panic when I have to speak without preparation in the 1 2 3 4 5
English class.
10. I worry about the consequences of failing my English class. 1 2 3 4 5
11. I don't understand why some people get so upset over foreign 1 2 3 4 5
language classes.
12. In English class, I can get so nervous I forget things I know. 1 2 3 4 5
13. It embarrasses me to volunteer answers in my English class. 1 2 3 4 5
14. I would not be nervous speaking English with native speakers. 1 2 3 4 5
15. I get upset when I don't understand what the teacher is correcting. 1 2 3 4 5

16. Even if I am well prepared for the English class, I feel anxious about 1 2 3 4 5
it.
17. I often feel like not going to my English class. 1 2 3 4 5
18. I am afraid that my language teacher is ready to correct every 1 2 3 4 5
mistake I make.
19. I feel confident when I speak in the English class. 1 2 3 4 5
20. I can feel my heart pounding when I'm going to be called on in 1 2 3 4 5
class.
21. The more I study for a English test, the more confused I get. 1 2 3 4 5
22. I don't feel pressure to prepare very well for the English class. 1 2 3 4 5
23. I always feel that the other students speak English better than I do. 1 2 3 4 5
24. I feel very self-conscious about speaking English in front of other 1 2 3 4 5
students.
25. Language class moves so quickly I worry about getting behind. 1 2 3 4 5
26. I feel more tense and nervous in my English class than in any other 1 2 3 4 5
class.
27. I get nervous when I am speaking in my English class. 1 2 3 4 5
28. When I'm on my way to English class, I feel very sure and relaxed. 1 2 3 4 5

29. I get nervous when I don't understand every word of the language 1 2 3 4 5
teacher
30. I feel overwhelmed by the number of rules one has to learn to 1 2 3 4 5
speak English.
31. I am afraid that the other students will laugh at me when I speak 1 2 3 4 5
English.
32. I would probably feel comfortable around native speakers of 1 2 3 4 5
English.
33. I get nervous when the instructor asks questions that I haven't 1 2 3 4 5
prepared.