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What is your age group?
 
18-19
 
20-21
 
22-24
 
25+
 
 
 
What is your sex?
 
Male
 
Female
 
 
 
Do you do any activities before coming to this class?
 
yes
 
no
 
 
 
If so what activity do you do?
 
Work
 
Prior class
 
Rest
 
other
 
 
 
 
How long do you perform that activity for? (in hours)
 
0-3
 
4-6
 
7+
 
 
 
Do you think the activity performed affects your attentiveness?
 
Yes
 
No
 
 
 
If so how attentive are you during class?
 
Very Attentive
 
Somewhat Attentive
 
Neutral
 
Non-attentive