1. About how much time do you usually spend on weekdays
watching television or videotapes?
A) none at all
B) 1 hour or less
C) between 1 and 2 hours
D) between 2 and 3 hours
E) more than 3 hours
2. Which of the following types of TV programs do you
watch most often?
A) sitcoms
B) movies
C) science and nature programs
D) soap operas
E) news programs
F) sports
G) music/entertainment
3. Where do you use a computer?
A) I don't use a computer at all
B) I use a computer only in school
C) I use a computer only at home
D) I use a computer both at school and at home
4. How often do you use a computer?
A) I never use a computer
B) at least once a day
C) once or twice a week
D) once or twice a month
E) less than once a month
5. Which best describes your use of the Internet?
A) I never use the Internet myself
B) my teacher uses the Internet during class and
students watch
C) I use the Internet myself occasionally
D) I use the Internet myself regularly
6. Which best describes your experience with Science
Fairs?
A) our school has never had a Science Fair
B) I take part in the Science Fair every year
C) I sometimes take part in the Science Fair
D) although my school has a Science Fair I have never
taken part
E) I am not interested in taking part in a Science Fair
7. How many hours a week do you spend in school involved
in organized activities (e.g., sports, band, choir, clubs,
etc.)?
A) none or less than 1 hour a week
B) between 1 and 2 hours a week
C) between 2 and 3 hours a week
D) between 3 and 4 hours a week
E) more than 4 hours a week
9. Which do you read most often?
A) comics and/or cartoons
B) news magazines
C) sports or fashion magazines
D) special interest magazines (e.g., science, computers,
etc.)
E) newspapers
10. Which types of books do you read most often?
A) science or horror fiction
B) general fiction or classics
C) poetry or plays
D) fantasy or romance
E) non-fiction
11. How may hours a week do you spend outside of school
reading for pleasure (including magazines)?
A) none or less than 1 hour a week
B) between 1 and 2 hours a week
C) between 2 and 3 hours a week
D) between 3 and 4 hours a week
E) more than 4 hours a week
12. How many hours sleep do you normally get each night
during the week?
A) 10 hours or more
B) 9 hours
C) 8 hours
D) 7 hours
E) 6 hours or less
13. How much time do you spend per week in volunteer
activities?
A) none or less than 1 hour a week
B) between 1 and 2 hours a week
C) between 2 and 3 hours a week
D) between 3 and 4 hours a week
E) more than 4 hours a week
14. Which best describes your activities with respect to
music (choir/glee club, band /orchestra)?
A) I am involved in one or more, both in and out of
school
B) I am involved in one or more in school only
C) I am involved in one or more outside school only
D) I play an instrument or sing but not in any musical
group
E) I am not involved in any musical activities
15. Which best describes your activities with respect to
the fine arts (drama, dance and the visual arts)?
A) I am involved in one or more, both in and out of
school
B) I am involved in one or more in school only
C) I am involved in one or more outside school only
D) I am not involved in any of these activities
16. Which best describes your assigned written homework to
be completed at home?
A) every night in several subject areas
B) every night - in one or two subject areas
C) two or three times a week
D) once a week
E) I rarely have assigned written homework
17. Which best describes your homework activity?
A) I rarely do any homework
B) I do my homework on my own
C) I do my homework on my own and someone at home
sometimes checks it
D) I do my homework on my own and someone at home always
checks it
18. Do you belong to any sports teams (soccer, baseball
etc.) or take part in organized physical activity
(aerobics, swimming, tennis, etc.)?
A) I am involved in one or more of these activities both
in school and outside of school
B) I am involved in one or more of these activities at
school only
C) I am involved in one or more of these activities
outside school only
D) I am not involved in any of these activities at all
19. Are there any barriers that affect your participation
in
extra-curricular activities after school?
A) no transportation for me to stay after school
B) have a part-time job
C) physically disabled
D) I do not wish to participate
E) very few activities offered at school
F) no barriers
20. Which of the following best describes your involvement
in school committees (including Student Council)?
A) I am currently a member of one or more school
committees
B) I have been a member of a school committee in the
past but am not a member any longer
C) I would like to join school committees but have not
yet had the opportunity
D) I am not interested in joining a school committee
21. What is your favourite out-of-school activity?
A) organized team sports or physical activity (including
roller-blading, skate boarding, etc.)
B) using a computer (surfing the Net, developing
programs etc.)
C) listening to music, watching TV or videos, or playing
video games
D) reading or playing a musical instrument
E) hanging out with friends
22. Which best describes your experiences with public
speaking or debating?
A) I really like speaking in public or debating and take
part regularly
B) I enjoy public speaking and debating and take part
occasionally
C) I have tried public speaking or debating but I find
it difficult
D) I am not interested in public speaking or debating
23. How much time do you spend each week working for
payment?
A) none at all
B) less than 5 hours
C) 5-10 hours
D) 10-20 hours
E) more than 20 hours