August 10, 20176

Suzette Alino
Headmaster of Ateneo Grade School

Dear Maam:
I am writing to request permission to conduct a research study at thisinstitution. I am currently
enrolled in the program at Ateneo de Davao Univeristy and am in the process of writing my
Masters Thesis. The study is entitled Health Related Quality of Life Among Pre-school
Pupils of Ateneo de Davao University: Basis of a Proposed School Health Program
I hope that the school administration will allow me to conduct a survey from the school to
anonymously complete a questionnaire for pupils with the assistance of their assistant teache
and a questionnaire for their parents . I will be given a consent form to be signed by their parent
or guardian at the beginning of the survey process
If approval is granted, pupils will complete the survey in the classroom allotting 20 minutes while
the parents will complete the questionnaire on a quiet setting on the school site during recess,
school time, lunch, after school and ask permission for use of this time as well. The survey
process should take no longer than 20 minutes . The survey results will be pooled for the thesis
project and individual results of this study will remain absolutely confidential and anonymous.
Should this study be published, only pooled results will be documented. No costs will be
incurred by either your school/center or the individual participants.
Your approval to conduct this study will be greatly appreciated. I would be happy to answer any
questions or concerns that you may have at that time. You may reach me at my mobile number
09053313869.
If you agree, kindly sign below and return the signed form in the blank provided .. Thank you.
Sincerely,
Sevilleja, Socorro Bernadete G.
Researcher

Permission to conduct a research study entitled: Health-Related Quality of Life Among

Preschool Pupils of Ateneo de Davao University: Basis of a proposed School Health Program

Approved by:

_____________________
Print your name and title here

____________________
Signature

_________
Date