Appendix B

I. Learner’s Profile
Please fill in the data needed in this questionnaire. This is not a test, please answer as honestly as you can. All answers
will be treated with strict confidentiality.

Name: ____________________________________
School: ___________________________________ Address: _______________________________

a. Age: _____
b. Sex:  Male Female
c. Parents’ Highest Educational Attainment (Check the box corresponding to your choice)
Father Mother
 Elementary Undergraduate  Elementary Undergraduate
 Elementary Graduate  Elementary Graduate
 High School Undergraduate  High School Undergraduate
 High School Graduate  Vocational Undergraduate
 Vocational Undergraduate  Vocational Undergraduate
 Vocational Graduate  Vocational Graduate
 College Undergraduate  College Undergraduate
 College Graduate  College Graduate
 With MA units  With MA units
 MaEd Graduate  MaEd Graduate

d. Parents’ Occupation (Check the box corresponding to your choice)

Father Mother
 Farmer  Farmer
 Fisherman  Fisherman
 Construction Worker  Construction Worker
 Laborer  Laborer
 Driver  Driver
 Vendor  Vendor
 Private Employee  Private Employee
 Overseas Filipino Worker  Overseas Filipino Worker
 Other (Please specify) __________  Other (Please specify) __________

e. Parents’ Monthly Income

 5,000 and below
 5, 001 – 10, 000
 10, 001 – 15, 000
 15, 001 – 20, 000
 20, 001 and above

II. Reading materials available at home and at the school (Put check mark as to as many reading materials as you read)
Home School
 Newspaper  Newspaper
 Magazine  Magazine
 Books  Books
 Learner’s Module  Learner’s Module
 Dictionary  Dictionary
 Encyclopedia  Encyclopedia
 Storybook  Storybook

III. Score in Pre-Test

IV. Score in Post-Test