The Effects Os Broken Families to the Social Life of Selected Smc...

Page 1 of 2

The Effects Os Broken Families to the Social Life of Selected Smcb Hs Students Sy 2010-2011

By | December 2010
Page 1 of 2
Survey Form

Praised be Jesus and mary!

The Fourth year students of St. Mary's College of Baliuag S.Y 2010-2011 is conducting a research paper . In line with that, the researchers, Pauline Vasallo and Rica Piamonte will be fascilitating a survey on the effects of broken family to the social life of selected SMCB students S.Y 2010-2011 to get a further information on the mentioned topic. We hope to get a favorable response on this matter. We hope that you will take this seriously. Your answers will be treated with confidentiality.

Name:________________________________ Section: ____________________ Age:_____

Please shade the appropriate box.
1. Profile

• With whom you are living with?


others (please specify):__________________________________________

• Your behavior towards other people:


• How many friends do you have?

1-3 friends 4-7 friends 8 and above

2. Does having a broken family have a negative effect on your social life?

Yes No
Why/why not?_______________________________________________________

3. Since you are from a broken family, do you think you will be having a negative camarederie (pakikipag-kapwa tao)?

Yes No

Why/why not?_______________________________________________________


• What are your advantages of having a broken family?

More Independent More Responsible

others (please specify):___________________________________________

• What are your disadvantages of having a broken family?

less caring Attention will be lessen Negative effect on the study

others (please specify):___________________________________________

5. What are the negAtive effects of having a broken family?

Drinking Smokingusing Drugs

others (please specify):___________________________________________

Thank you for answering our survey. All information given above will be served with...