Good day, student/s! You are now invited to answer our questions below.

Together, this our research study entitled, The Number of Students who are
afraid of Speaking in Public. People whose suffering from Social Anxiety. The
purpose of this research is to determine the number of students who are literally
and emotionally afraid of speaking in public. Hope to get your honest answers!
This is a completely voluntary survey. Thank you for your cooperation!

Sincerely yours,
Hannah Andres
Erika Cervas
Arvi Aquino
Richard Villanueva
Sherwin Calado

Name: _______________________ Section: ____________ Date: _________

A. Read the questions and just answer YES or NO on the blank space.

_____ 1. Are you afraid of speaking in public?

_____ 2. Can you do speaking in public in front of many people (ex: doing
some presentation, explaining, etc.) Without your friend to motivate you?

_____ 3. Are you afraid to raise your hand when it comes to reciting and you
know the answer?
B. In each of the following situations, rate the amount of your fear/anxiety you
feel using the scale below.

1 – None 2 – Some 3 – Moderate 4 – High

____ 1. Saying “Hello” to a stranger.

____ 2. Giving a presentation to your work team or to a group in school.
____ 3. Interrupting someone else to say something during a conversation.
____ 4. Reading out loud from a book in your class.
____ 5. Hosting a small party with only friends.
____ 6. Saying “Good morning” to some teachers you categorize as an
authority figure.
____ 7. Talking to a friend during lunchtime.
____ 8. Accidentally dropping your food at a busy food court in school.
____ 9. Talking to other students before your mathematics class begins.
____ 10. Asking your teacher for some help because you’re having a hard
time to understand the lesson.

C. Put a check on the box if you are experiencing the situation we gave and
leave it blank if you don’t.

An intense and persistent fear of a social situation in which people

might judge you.
Fear that you will be humiliated by your actions.
Fear that people will notice that you are trembling,
sweating, or showing other signs of being afraid.
Knowing that your fear is excessive or unreasonable (ex: reciting,
public speaking, etc.)
Always feel anxious or nervous especially about what may happen.
Go to great lengths to avoid participating.
 You feel worry if you make a fool of yourself or feel you have been
made to look foolish?
Do you feel uncomfortable when you meet new people?
Do you cross the street to avoid meeting someone?
Do you feel that other people are better than you?

D. Answer the last question.

 What do you think will happen if you stayed in that situation and you did
not seek for help to overcome that fear/anxiety?