Republic of the Philippines

Department of Education
Region VIII (Eastern Visayas)
Division of Leyte
Babatngon II District
PAGSULHUGON NATIONAL HIGH SCHOOL
Brgy. Pagsulhugon, Babatngon, Leyte

SCHOOL SURVEY ON CHILD PROTECTION POLICY AND ANTI-BULLYING

Pagsulhugon National High School is interested in finding out how you are. It seeks
to find out the extent to which the DepEd has done whatever was necessary to prepare its
students in school and to determine what additional assistance the department can render to
its students. Please respond frankly and feel free to put additional comments.

A. PERSONAL DATA

Put a check ( / ) mark on the space provided for you.

Name (Optional) ______________________________

Age 11-13 _____ Sex

14-16 _____ Male _______
17 and above _____ Female _______

Number of Family Members

1-2 _____ 3-4 _______
5-6 _____ 7-8 _______
More than 8 _____

B. GENERAL SATISFACTION
Think about your overall experience in classes, extracurricular activities and social
events. Select the option that best represents how you fee. The following are some of
the experienced by people your age. Please help us identify which you experience
and whether you believe the Department of Education should help you with these
experiences.
ITEM STRONGLY DISAGREE AGREE STRONGLY
DISAGREE AGREE
A. MYSELF (CHILDREN/LEARNERS)
1. I enjoy being in school.
2. I enjoy learning in school.
3. I enjoy being with my classmates.
4. I feel relax with my friends.
5. I feel safe when I am at school.
6. I take part in school activities outside of
lessons like clubs, sports, music and arts.
7. I don’t have problem in school.
Page 1 of 2
 B. MY TEACHERS
1. My teachers help me to do my best.
2. My teachers give me work those challenges
me
3. My teachers listen to what I say during
learning sessions.
4. My teachers is also my friend.
5. My teachers help me with my lessons.
6. My teachers provide necessary learnings for
my growth.
7. My teachers help me solve my problems.
C. MY SCHOOL
1. My school encourages me to look after my
physical health.
2. My school encourages me to look after my
emotional and mental health.
3. My school encourage me to be independent
and take on responsibilities.
4. My school encourages me to respect people
from different backgrounds and to treat
everyone equally.
5. My school provides me guidance about next
steps.
6. In my school, bullying is not a problem.
7. There is an assigned adult at school I can
talk with, if there is something worrying me.
D. MY CLASSMATES
1. My classmates carry guns or knives at school.
2. My classmates threaten to hurt other students.
3. My classmates steal money, electronics, or other
valuable things while at school.
4. My classmates damage or destroy other
students’ properly.
5. My classmates fight a lot.
6. My classmates are teased or picked on about
their physical or mental disability.
E. SELF-EXPRESSION ESSAY
1. My biggest concern is ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. My fear are ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
3. I hate ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Page 2 of 2