The Example of Questionnaire

CODE QUESTIONNAIRE
This Questionnaire has the purpose to identify the correlation between the habit of watching English subtitle movies and Reading Comprehension achievement. All of the questions are for any movie or serial which uses English as the subtitle. Please be honest in answering every single question. This questionnaire is purely for conduct a thesis in order to get the data. It will not affect your score mark at a certain lesson. Last, your data will be private for the researcher only. Thank you.
Name: ______________________|

Have you watched at least 1 movie with English subtitles in the past two years?

a. Yes.
b. No. Specific Question
2. How many movies with English subtitles that you watch in a month?

a. More than 10 titles
b. 8 – 10 titles
c. – 7 titles d. 2 – 4 titles
e. Only 1 title

3. For the movie with multiple-episode (serial), how many episodes you watch in a month?

a. More than 30 episodes
b. 21 – 30 episodes
c. 13 – 20 episodes
d. 5 – 12 episodes
e. 1 – 4 episodes

4. How often do you watch a movie with English subtitle?

a. Every single day (no day without movie)
b. Almost everyday
c. Twice or third in a week
d. Once a week
e. Once a month

5. How many times do you spend watching movies with English subtitles in a day?

a. More than 5 hours
b. Around 5 hours
c. Around 3 – 4 hours
d. Around 2 hours
e. Less than an hour

6. Rank the reasons for watching movie with English subtitles on it: Habitual. Curious the cultural life as seen as in the movie. Like the storyline or the topic of the movie. Enjoying free time rather than other activities. What language do you prefer in a movie with a foreign language? (English include)

a. English subtitle
b. Bahasa subtitle
c. Original language subtitle
d. No subtitle but English dubbing
e. No subtitle but Bahasa or original dubbing

7. The most reason of choosing English subtitle more than another subtitle (Bahasa or another language)

a. Improving English
b. Understandable
c. More interesting
d. The available one
e. Accidental

8. How does your habitual of watching movies impact your time to study?

a. Prefer watching movies than study
b. Study at first but can not concentrate, my mind is on the movie
c. Watch a movie while studying
d. Concentrate to finish studying at first, then watching movie
e. Prefer studying than watching a movie

9. What do you do when you find difficulties in understanding the subtitle?

a. Replay back immediately to the part that I lack understanding
b. Keep the movie goes and replay it again after the end
c. Ask friends/try to find the summary or review of the movie
d. Let the movie goes try to find the meaning over the actor/actress action
e. Just let the movie goes and ends

10. What do you do after watching a movie with English subtitles?

a. Find and watch other movies
b. Make a review, summary, or deep analysis
c. Discuss with friends
d. Replay it again
e. Nothing to do, it is just for fun

11. Where do you get movies with English subtitles?

a. Purchase CD/DVD online or offline
b. Rent CD/DVD in the rental
c. Download free online
d. Copy from friends
e. Accidental

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