University of Cordilleras
College of Information Technology / Computer Science
Name(Optional):________________AGE:____GENDER:____
1. Do you have Internet connection at home?
Yes No
2. Do you spend time at computer shops?
Yes No
3. What is your average grade for the 1st term?
95-99 80-84
90-94 75-79
85-89 74-below
4. How many hours do you spend on the Internet?
1-2 hours 5-6 hours Others, Please specify:_____
2-3 hours 6-7 hours
4-5 hours 7-8 hours
5. What is your study habit?
Review then use Internet Review along with Internet use
Use Internet then review Others, Please specify:____
6. What is your purpose for using the Internet?
Academic/School purposes Non-academic related research
Entertainment/Leisure/Gaming Others, Please specify:___
7. Do you have anyone to supervise or accompany you at home?
No, I live alone Yes, my parents/siblings
Yes, my guardians
8. How many subject/s did you drop/fail for the 1st trimester?
1 4 5 7 None(skip#7)
2 3 6 8
9. Is your failure or decision of dropping subject/s cause by
Internet usage?
Yes No
10. Overall, how does your use of Internet affect your
school/academic performance?
Positive Negative