Survey Instrument
Factors Influencing Late Submission of Academic Tasks
in Alternative Learning Delivery Mode
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Instructions:
Please answer all questions honestly.
For the rating scale questions, select the number that best represents your opinion or
experience.
For open-ended questions, write your response clearly and thoughtfully.
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Part 1: Demographic Information
Age: ______________________________________
Gender: ☐ Male ☐ Female ☐ Others: _____________________
Year Level: ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ Others: _____________________
Program/Course: __________________________________________________
Do you have regular access to the internet at home? ☐ Yes ☐ No
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Part 2: Factors Influencing Late Submission
Please rate your agreement with the following statements based on your experience in
alternative learning delivery.
Scale:
1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree
Statement 1 2 3 4 5
I experience ☐ ☐ ☐ ☐ ☐
technical
problems
such as slow
or unstable
internet
connection
when
submitting
tasks.
I have ☐ ☐ ☐ ☐ ☐
difficulty
managing
my time
effectively
between
school tasks
and personal
responsibilit
ies.
I feel ☐ ☐ ☐ ☐ ☐
unmotivated
to complete
academic
tasks on
time in the
alternative
delivery
mode.
Lack of ☐ ☐ ☐ ☐ ☐
immediate
interaction
or feedback
from
teachers
delays my
task
submission.
I find the ☐ ☐ ☐ ☐ ☐
instructions
for academic
tasks
unclear or
difficult to
understand.
Household ☐ ☐ ☐ ☐ ☐
distractions
(e.g., noise,
chores,
family
responsibilit
ies) affect
my ability to
submit tasks
on time.
I experience ☐ ☐ ☐ ☐ ☐
health issues
or fatigue
that prevent
me from
submitting
tasks
promptly.
I have ☐ ☐ ☐ ☐ ☐
limited
access to
necessary
learning
materials or
devices (e.g.,
laptop,
printer) for
completing
tasks.
I struggle ☐ ☐ ☐ ☐ ☐
with self-
discipline
when
working
independent
ly on tasks.
I face ☐ ☐ ☐ ☐ ☐
difficulties
in
understandi
ng the
subject
matter
which delays
task
completion.