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Survey Questionnair 035324

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IMPACT OF LOW SELF-ESTEEM ON THE ACADEMIC PERFORMANCE OF

GRADE 7 STUDENTS AT NAGOTGOT HIGH SCHOOL

I. Instructions: Please answer all questions honestly and to the best of


your ability. Your responses will be kept confidential and used only for
research purposes.

1. Age: _____ years old


2. Sex:
o Male
o Female

3. Academic Standing (Please circle one)


o Honors
o Non-honor student
o Failing students

4. Family’s Economic Status: (Please circle one)


o Low Income
o Middle Income
o High Income
II. Instructions: Please rate your agreement with the following statements
using the scale below:

 1 = Strongly Disagree
 2 = Disagree
 3 = Agree
 4 = Strongly Agree

Statement 1 2 3 4 5
I am confident in my ability to succeed academically.

I believe I am good at school work.

I feel proud of my academic achievements.

I worry about failing in school.


I feel embarrassed about my academic performance.

I avoid participating in class because I fear being


wrong.

I feel like I don’t belong in this school.

I feel like I am not good enough.


I have difficulty concentrating in class due to my
feelings.

I have trouble making friends because of my self-


esteem.

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