To whom this may concern,
Good Morning!!!
I am currently conducting my study regarding the “Effects of Bullying on the Academic
Performance of Grade 9 and Grade 10 Students in Tala National High School”. I am so pleased to get
honest opinions and answers from all of you. All your kindness are highly appreciated. Rest assure that
the responses I’ll be getting from you will be confidential and will be only used as data for my study.
Thank you for your merit consideration. God bless you richly.
Sincerely yours,
Sherwin L. Baral
GRADE 10 STUDENT
(RESEARCHER)
RESEARCH TITLE: Effects of Bullying on the Academic Performance
of Grade 9 and Grade 10 Students in Tala National High School
Part I: Personal Information
Direction: Fill in the correct information.
Name: ____________________ Gender: _________________
Age: __________________ Grade Level: ______________________
Part II: Shade your answers.
SELF-QUESTIONNAIRE
1. What kind of bullying did you experience?
○ Physical Bullying
○ Verbal Bullying
○ Social Bullying
○ Cyber Bullying
○ Sexual Bullying
○ Prejudicial Bullying
○ Mental Bullying
2. When were you bullied?
○ 6 year-old and below
○ 7-9 year-old
○ 10-12 year-old
○ 13-15 year-old
○ 16 year-old and above
3. Who did you tell?
○ Parents/ Family
○ Teachers/ Trusted adults
○ Friends/ Classmates
○ No one
4. How long did you experience bullying?
○ Just a week/ month
○ For a couple of months
○ For 1 year
○ For 2- 3 years
○ More than 3 years
Part III: Causes of Bullying
STRONGLY AGREE DISAGREE STRONGLY
CAUSES AGREE DISAGREE
1. Lack of involvement in child’s
interests, activities and daily life.
2. Lack of Supervision
3. Overly permissive, lack of limits
4. Unsupervised student areas such
as lunchrooms, bathrooms,
playground
5. Apathy towards bullying on the
part of teachers and
administrators
6. Racism
7. Sexism
8. Appearance
9. Religion
10. Weight
11. School Performance
Note: If there are other causes of bullying that you know. Please specify.
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Part IV: Effects of Bullying
a. Positive Effects
STRONGLY AGREE DISAGREE STRONGLY
POSITIVE EFFECTS AGREE DISAGREE
1. Increase interest in school and
extra-curricular activities
2. No complaints of illness to avoid
attending school
3. Boost confidence
4. Showing his/her best to
overcome bullying through
studying well and aiming to get
good marks
5. Increase interests in school work
6. Become more concentrate in
studies
Note: If there are other positive effects of bullying on the academic performance of students that you
know, please specify.
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b. Negative Effects
STRONGLY AGREE DISAGREE STRONGLY
NEGATIVE AGREE DISAGREE
EFFECTS
7. Loss of interest in school and
extra-curricular activities
8. Frequent complaints of illness to
avoid attending school
9. Loss of confidence
10. Seems afraid of going to school,
riding the bus, walking to school,
or taking part in organized
activities with peers
11. Anxiety or low-self esteem
12. Lack of interests in school work
13. Cannot concentrate in studies
Note: If there are other negative effects of bullying on the academic performance of students that you
know, please specify.
_____________________________________________________________________________________
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_____________________________________________________________________________________
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Part V: Answer the following questions:
1. How effective are anti-bullying programmes in school?
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2. What advice would you like to give to victims of bullying?
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3. Why is it important for students to advocate themselves against bullying?
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4. How are you going to help students that are being bullied also?
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5. What should children and teens do if someone tries to bully them?
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6. What do you think educators can do to easily resolve cases of bullying in your school?
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