INSTRUCTIONS: Please print out the questionnaire and answer the questions as best you can in the space provided. You can write clarifying notes in the margin if needed. NOTE: Responses to all questions will be kept anonymous. I need your name to make sure you have done the assignment, and to correlate the data with other questionnaires. However, if there is a question you find alarming or offensive, just don't answer it. Thanks for your participation!
Your Name: ___________________________________ (important!)
| 1. | What is your major? | ____________________ |
|---|---|---|
| 2. | What year are you? | Freshman | Sophomore | Junior | Senior |
| 3. | What is your GPA? | ____________________ |
| 4. | Do you work while going to school? | Don't work | Part-time | Full-time |
| 5. | How many hours do you study per 7-day week in a typical semester? | ____________________ |
| 6. | How many units of alcohol do you drink in a typical 7-day week while at school? One unit of alcohol is equal to one bottle of beer, or one glass of wine or one mixed drink. | ____________________ |
| 7. | How many nights a week (including weekend) do you go out with friends? | ____________________ |
| 8. | How tall are you? | ____________________ |
| 9. | How much do you weigh? | ____________________ |
| 10. | What color is your hair right now? | ____________________ |
| 11. | Do you color your hair? | ____________________ |
| 12. | What were your VERBAL SAT scores? | ____________________ |
| 13. | What were your MATH SAT scores? | ____________________ |
| 14. | What country do you come from? | ____________________ |
| 15. | What language are you most comfortable speaking? | ____________________ |
Thank you!