Liceo de Cagayan University

RNP Boulevard, Kauswagan, 9000 Cagayan de Oro City

Member: Philippine Association of Colleges and Universities-Commission on Accreditation
(PACU-COA)
SCHOOL OF TEACHER EDUCATION
Tel. No. (8822) 722244/(088)8584093 to 95 local 230/228
Granted: LEVEL 4 PACU-COA

Dear Students:
Good day!
Our group is conducting an action research study entitled “IMPLICATIONS FOR
STUDENTS’ ENGAGEMENT AND PERFORMANCE IN FACE TO FACE SETTING AS A RESULT OF
MODULAR INSTRUCTION.” This study is designed to determine the effect of modular instruction
to students’ engagement and performance particularly in reading and writing.

Thus, we would like to ask for your cooperation and honesty by allowing us to make you
as one of our participants. Any information gathered will remain confidential and will be used
solely for the purpose of this study. We assure you that your participation in the study will not
cause you any risks or discomfort. Your cooperation to this request will be highly appreciated.
Thank you and God bless!

Sincerely yours,
The Researchers

Directions: Determine your level of agreement with the statements below by putting a check mark in the box.
Kindly answer each question honestly and make sure not to leave any item unanswered.

Scale:

5- Strongly Agree
4- Agree
3- Neither Agree nor Disagree
2- Disagree
1- Strongly Disagree

PART I. STUDENTS’ ENGAGEMENT

1 2 3 4 5
STRONGLY DISAGREE NEITHER AGREE STRONGLY
DISAGREE AGREE NOR AGREE
DISAGREE
I always raise my hands in class.
I like to share my thoughts in class.
I feel happy joining in with
classroom discussions.

I participate actively in small

group discussions.
I always involve myself in the
teaching and learning process.
I discuss my ideas to my fellow
classmates.
 Liceo de Cagayan University
RNP Boulevard, Kauswagan, 9000 Cagayan de Oro City
Member: Philippine Association of Colleges and Universities-Commission on Accreditation
(PACU-COA)
SCHOOL OF TEACHER EDUCATION
Tel. No. (8822) 722244/(088)8584093 to 95 local 230/228
Granted: LEVEL 4 PACU-COA

I love to ask questions during class

lectures.
I always make sure to engage with
the teacher during classroom
lectures.
I like to be around with other
people.
I prefer to work in a group than to
work alone.

PART II: LEVEL OF STUDENTS’ READING SKILLS

1 2 3 4 5
STRONGLY DISAGREE NEITHER AGREE STRONGLY
DISAGREE AGREE AGREE
NOR
DISAGREE
I enjoy reading the books that
are given in class.
I can easily understand what I
read.
I can synthesize what I read. (i.e.,
combine information to see how
it all fits together).
I am able to recall what I have
read.
I enjoy reading lengthy
paragraphs.
I understand the structure of the
educational material that I read.
I am a fast reader.
I can identify main ideas.
I can interpret and evaluate what
I read.
I can easily summarize what I
read using my own words.
 Liceo de Cagayan University
RNP Boulevard, Kauswagan, 9000 Cagayan de Oro City
Member: Philippine Association of Colleges and Universities-Commission on Accreditation
(PACU-COA)
SCHOOL OF TEACHER EDUCATION
Tel. No. (8822) 722244/(088)8584093 to 95 local 230/228
Granted: LEVEL 4 PACU-COA

PART III: LEVEL OF STUDENTS’ WRITING SKILLS

1 2 3 4 5
STRONGLY DISAGREE NEITHER AGREE STRONGLY
DISAGREE AGREE NOR AGREE
DISAGREE
I can write a good academic
paragraph.
I can logically organize my ideas
when I write something.
I can use appropriate strategies in
writing.
I can use appropriate spelling,
capitalization, and punctuation.
I can write quickly and effectively
even under time constraints.
I can summarize educational
materials in my own words in
writing.
I can make an outline of the
material in writing.
I use appropriate grammar and
punctuation to emphasize
meaning.
I love writing essays, stories, and
poems.
I can easily put my ideas into
words.