sample questionnaire for thesis

1. UNIVERSITY OF CALOOCAN CITY
Graduate School
Dear Sir/Madam:
The undersigned is conducting a study on the “TEACHERS’
ONLINE LEARNING DELIVERY AND LEARNERS'
PARTICIPATION AND PERFORMANCE: BASIS FOR A
PROPOSED COACHING AND MENTORING PLAN”. Your
kind participation with regards to the questionnaire accompanying this
request will be highly appreciated.
Please accomplish the questionnaire as honest as you can base
on your own assessment and experiences. In this regard, all the data
gathered will be treated with strict confidentiality and will be used for
academic purposes only.
Thank you very much!
Very truly yours,
CHRISTIAN GIL H. CHAVEZ JR.
Researcher

2. UNIVERSITY OF CALOOCAN CITY
Graduate School
SURVEY QUESTIONNAIRE
Name: (Optional) _____________________________________________
Part I
1. Demographic Profile
Direction: Please put a check mark ( / ) on the blank that best represent your
answer to the following information.
1.1.Age
______ 21 – 24 years old
______ 25 – 34 years old
______ 35 – 44 years old
______ 45 – 54 years old
______ Above 54 years old
1.2.Gender
_______Male
_______ Female
1.3.ICT Related Training
______ Basic troubleshooting seminar
______ Video conferencing seminar
______ Learning Management Systems
______ Others

3. UNIVERSITY OF CALOOCAN CITY
Graduate School
1.4.Latest Performance Rating
______ 4.500-5.000 - Outstanding
______ 3.500- 4.499 - Very Satisfactory
______ 2.500- 3.499 - Satisfactory
______ 1.500 – 2.499 - Unsatisfactory
______ Below 1.499 - Poor
1.5.Number of years of teaching experience
______1 – 5 years
______ 6 – 10 years
______ 11 – 15 years
______ 16 – 20 years
______ 21- 25 years
______ 25 – 30 years
______ 31 years above

4. UNIVERSITY OF CALOOCAN CITY
Graduate School
Part II. Status of teacher’s online instruction delivery.
Directions: Please read carefully and give your honest assessment on the status of the
teacher’s online instruction delivery by writing a check mark ( √ ) on the appropriate
column opposite the given items. Please be guided by the following scale where;
Rating Scale Interpretation
4 Highly Attained (HA)
3 Attained (A)
2 Moderately Attained (MA)
1 Not Attained (NA)
2.1. Assessment of learning outcomes
No. Indicators 4(HA) 3(A) 2(MA) 1(NA)
1
The assessment of learning outcomes is
in line with the learning goal.
2
The usage of instructional materials
provides a number of useful evaluation
tools.
3
The Pre-test and Post-test are suited to
the objectives and goals of the
curriculum.
4
Test items are presented in simple and
precise language.
5
The items from the assessment tools are
appropriate for the learner’s ability level.
6.
The test items defines level of learner’s
achievement towards an outcome.
7.
The usage of instructional materials are
accessible to the learner’s.
8. No duplication of learning materials.
9
The instructional material are responsive
to change.
10
The assessment tool is relevant and
interesting.

5. UNIVERSITY OF CALOOCAN CITY
Graduate School
2.2. On content selection
No. Indicators 4(HA) 3(A) 2(MA) 1(NA)
1
The content support the instructional
objectives.
2
The contents are arranged in logical
sequences.
3
The contents adequately cover the
objectives of the lesson
4
The contents are relevant, interesting and
self-motivating learners.
5
The concept for each activity are
arranged logically to ensure that there is
no duplication of the content.
6
The contents are accessible to the
learners.
7
The contents are suitable to the learner’s
ability level.
8 The content are timely and updated.
9
The contents are comprehensible and
easy for the learners to understand.
10 The contents are responsive to change.
2.3. Preparation of objectives 4(HA) 3(A) 2(MA) 1(NA)
No. Indicators
1
The objectives are clearly stated in
behavioral terms.
2 The objectives are simple and specific.
3
The objectives can be accomplish within
the prescribe teaching period
4
The objectives of the materials are
suitable to the different learning
experience.
5 The objectives are result-oriented.
6 The objectives are relevant to the topic.
7
The objectives are attainable by the
learners.
8 The objectives are timely and updated.
9
The objectives suits the level of learners
ability.
10 The objectives are easy to understand.
2.4. Utilization of strategy

6. UNIVERSITY OF CALOOCAN CITY
Graduate School
No. Indicators 4(HA) 3(A) 2(MA) 1(NA)
1
Gives instruction that are clearly
understood and followed.
2
Strategy are simple and easily
understood
3
Teaching approach are appropriate and
relevant
4
Learning material used provide for a
variety of learning activities
5
The structure, style and format are
appropriate to the target level.
6 Timely and accurate
7 Responsive to change
8 Easy to used and impart.
9
Accessible to both learners and the
teachers.
10
Relevant, interesting and self-motivating
learners.

7. UNIVERSITY OF CALOOCAN CITY
Graduate School
Part III. Level of participation of the learners and the extent of the teachers’ online
instruction delivery.
Directions: Please give your honest assessment on the level of participation of the
learners and the extent of the teachers’ online instruction delivery in your school by
writing a check mark (√) on the appropriate column opposite the given items. Please
be guided by the following scale where;
Rating Scale Interpretation
4 High Level (HL)
3 Moderate Level (ML)
2 Low Level (LL)
1 Very Low Level (VLL)
3.1. Attendance
No. Indicators 4(HL) 3(ML) 2(LL) 1(VLL)
1
At least 75% of the learners are able to
attend online class.
2
Poor internet connection affects the
number of learners attending online class.
3
The number of learners taking online
classes is affected by power outages.
4
Personal/family issues that prevent
learners from joining in online classes.
5
Learners interest in the subjects makes
them hesitant to attend class.
6
The number of learners taking online
classes is affected by lack of access to the
internet.

8. UNIVERSITY OF CALOOCAN CITY
Graduate School
7
The number of learners taking online
classes is affected by lack of device to
used.
8
The learners are not well-versed in using
the internet.
9
The learners are not well-versed in using
technology related devices.
10
The online platform being used are not
easy.
3.2. Interactive discussion of the topics
No. Indicators 4(HL) 3(ML) 2(LL) 1(VLL)
1
At least 75% of the students are actively
participating in the online class.
2
Learners are able to express their ideas
during online class.
3
Learners are able to raise question during
the discussion
4
Learners are able to communicate during
discussion
5 Learners are interested in the discussion.
6
Learners are reluctant in using online
platform.
7
Learners internet connection is not
consistent
8
Learners devices is sluggish and not
suitable to online learning delivery.
9
Learners has family issues that affects
their level of participation
10
Learners environment are noisy and loud
background.
3.3. Presentation of the assigned activities
No. Indicators 4(HL) 3(ML) 2(LL) 1(VLL)
1
Learners are interested in the assigned
activities.
2
Assigned activities includes the
information necessary for completion
3
Difficulty to do multiple activities in
period of time.
4
Confusion results from doing multiple
activities at the same time
5
learner assigned to groups can cause
difficulty in doing their assigned activities

9. UNIVERSITY OF CALOOCAN CITY
Graduate School
6
Learners devices is sluggish and not
suitable to online learning delivery.
7
Learners internet connection is not
consistent
8
The learners are not well-versed in using
the internet.
9
The learners are not well-versed in using
technology related devices.
10
The online platform being used are not
easy.
3.4.
Timeliness in the submission of the
learning activity out-puts
No. Indicators 4(HL) 3(ML) 2(LL) 1(VLL)
1
At least 75% of the students are able to
pass their outputs on time.
2
The amount of learners who complete
their assignments on time is affected by
poor internet connections.
3
Power interruptions have an impact on the
number of students who pass their output
classes.
4
Learners personal/family concerns
prohibit them from submitting their work
on time.
5
Leaners interest for the subject activities
causes them to be cautious of passing their
activity outputs.
6
Learners devices is sluggish and not
suitable to online learning delivery.
7 Learners does not have a device to use.
8
The learners are not well-versed in using
the internet.
9
The learners are not well-versed in using
technology related devices.
10
The online platform being used are not
easy.