SURVEY QUESTIONNAIRE

Dear Respondents,
We, HUMSS student of INFOTECH COLLEGE OF ARTS AND SCIENCES
ANTIPOLO, We are working on a research , Factors Affecting the academic
Performances of LGBT in Selected Student at ANTIPOLO CITY SENIOR HIGH
SCHOOL. May we request to answer the questions in this survey questionnaire. The
information you provide will enable us to attain the purpose of the study. Thank you
very much for your Cooperation!

The Researchers

1. Demographic Profile:

Name: Age:
Gender: Strand/ Course:

DIRECTIONS : Please mark the column honestly with a check (/) if you’ve been

encounter the given Factors below.

FACTORS Specific Factors Specific Factors Checklist Checklist

(1) (2)
Verbal B Name Calling Homophobic or
Racist
Insult Verbal Abuse
Teasing Saying Bad Words
Physical B Hitting Tripping
Kicking Pinching
Cyber B Bash in facebook Ranting towards you
Chat a abusive Post you in
words SOCMED
Discriminatio Gender Identity Skintone color
n
Religious category Body,hair,dressing
Mental health Anxiety Depression
I.
LOS from fam It Lowers your self- Dissapointed to
and friends steem yourself