TECH

The following is a survey created by the TECH Crew for a study on teenage behaviors. The results of the survey will be displayed and compared in future months. Please answer all questions as honestly. Enjoy.

1. What is your sex?
   Male Female
   
   
2. What is your grade?
   8th Grade 9th Grade 10th Grade 11th Grade 12th Grade
   
   
3. What is your age?
   13 or younger yrs old 14 yrs old 15 yrs old 16 yrs old 17 yrs old 18 yrs old 19 or younger yrs old
   
   
4. Where are you from?
   North East Mid-Atlantic South Great Lakes
   Central Pacific (includes Hawaii & Alaska)
   
   
5. What is your financial status?
   Lower Class Middle Class Upper Class
   
   
6. What is your ethnic background?
   African American Asian Caucasian Hispanic
   Middle Eastern Native AmericanOther
   
   
7. With whom do you live?
   Two Natural Parents One Natural Parent
   A Natural Parent and a Stepparent Other Relative Guardian
   
   
8. What is the highest level of education completed by your female guardian (mother, stepmother, etc.)?
   Middle School High School College Graduate School
   
   
9. What is the highest level of education completed by your male guardian (father, stepfather, etc.)?
   Middle School High School College Graduate School
   
   
10. How many friends do you have?
    None Few Average Many
    
    
11. Is school important to you?
    Not Important Somewhat Important Important Very Important
    
    
12. How much homework do you do per day?
    Less than 1 Hour 1 Hour 2 Hours 3 Hours More than 3 Hours
    
    
13. When do you get the most work accomplished?
    Morning Afternoon Evening Late Night
    
    
14. How do you work best?
    Alone One Other Person Small Group Large Group
    
    
15. How much TV do you watch per day?
    Less than 1 Hour 1 Hour 2 Hours 3 Hours More than 3 Hours
    
    
16. Do you get detentions and or suspensions?
    Never Not Usually Sometimes Frequently
    
    
17. Are you involved in school sports?
    No Not Enough Time One Season
    More than One Season Every Season
    
    
18. Are you involved in other sports or extra-curricular activities?
    No Not Enough Time Somewhat Involved
    Moderately Involved Very Involved
    
    
19. Are you involved in hobbies or community activities?
    No Not Enough Time Somewhat Involved
    Moderately Involved Very Involved
    
    
20. Do you work?
    No Not Enough Time One Day per Week
    A Few Days per Week All Week Long
    
    
21. What do you do?
    
    
    
22. Why do you work?
    
    
    
23. What religious affiliation do you claim?
    Atheist Buddhist Catholic Protestant Hindu
    Jewish Mormon Muslim Eastern Orthodox Other
    
    
24. Is religion important to you?
    Not Important Somewhat Important Important Very Important
    
    
25. Are you influenced by your parents?
    Not at All Rarely Occasionally Usually Always
    
    
26. If yes are you more greatly influenced by your mother or father?
    Mother Father
    
    
27. Are you influenced by your siblings?
    Not at All Rarely Occasionally Usually Always
    
    
28. If yes are you more greatly influenced by your brother or sister?
    Brother Sister
    
    
29. Are you influenced by your friends?
    Not at All Rarely Occasionally Usually Always
    
    
30. Are you influenced by your boyfriend/girlfriend?
    Not at All Rarely Occasionally Usually Always
    
    
31. Are you influenced by your teachers?
    Not at All Rarely Occasionally Usually Always
    
    
32. Are you influenced by newspaper or magazine advertising?
    Not at All Rarely Occasionally Usually Always
    
    
33. Are you influenced by TV advertising?
    Not at All Rarely Occasionally Usually Always
    
    
34. Do you smoke?
    No Tried It Less than One Pack a Day One Pack per Day
    Two Packs per Day More than Two Packs per Day
    
    
35. Have you tried to quit smoking?
    Yes No
    
    
36. Do your parents smoke?
    No Mother FatherBoth
    
    
37. Do your parents allow you to smoke?
    Yes No
    
    
38. Do your friends smoke?
    Yes No
    
    
39. Do you drink alcohol?
    Not at All Rarely Occasionally Usually Always
    
    
40. Do your parents consume alcohol?
    No Mother FatherBoth
    
    
41. If so how often?
    Do Not Drink Rarely Occasionally Usually Always
    
    
42. Do your parents allow you to drink alcohol?
    Yes No
    
    
43. Do you use other drugs?
    Yes No
    
    
44. Do your parents use any other drugs?
    Do Not Use Drugs Rarely Occasionally Usually Always
    
    
45. Are you sexually active?
    Yes No
    
    
46. Do you have a license?
    Yes No
    
    
47. Do you wear a seat belt?
    Yes No
    
    
48. Do you believe the warning labels on cigarette packs and advertising?
    Yes No
    
    
49. Do you believe cigarette companies are honest?
    Yes No
    
    
50. If for any of the questions above you selected not enough time please delete the words "Enough Time" and very briefly tell us why?
    
    

Thank You

Thank you for taking the time to answer the questions in our survey.

The information collected through this survey serve two purposes. First, the information gives us a better understanding of how to better improve our site to fit your needs. Second, a tally of the results of our survey will be displayed for you to see how the majority responded to the survey. We recommend you check your responses before you submit your survey otherwise send it in and if there are any questions that you think should not have been included in this survey or if there is a question you would like to see in future surveys let us know in the feed back page which will follow the submission of this form.

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