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  2. 2013
  3. February
  4. D
  5. Domestic Violence Survey
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You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

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1. Are you currently a student enrolled in an accredited community college or university?
 
Yes
 
No
 
 
 
2. What is your gender identity?
 
female
 
Male
 
 
 
3. What is your sexual orientation?
 
Stright
 
Lesbian
 
Gay
 
 
 
4. Are you an immigrant to the United States, undocumented or otherwise?
 
Yes
 
No
 
 
 
5. Have you heard about Domestic Violence? If yes, Where?
   
 
 
6. Please answer: (5: Strongly Agree, 4: Agree, 3: Neither agree nor disagree, 2: Disagree, 1: Strongly Disagree
Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
I know a lot about domestic violence.
If I was the victim of Domestic Violence, I would feel comfortable reporting it to the police.
If someone I knew was experiencing Domestic Violence, I would feel comfortable reporting it to the police.
If I was the victim of Domestic Violence, I know where I can go to get support on campus.
If I was the victim of Domestic Violence, I know where I can go to get support off campus.
I am familiar with the process of reporting domestic violence to the police.
I am familiar with the legal options I have available to me if I were the victim of domestic violence.
 
 
7. what type of people are the targets of Domestic Violence?
Strongly disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
Women Remain Targets for Domestic Violence
Immigrant Women Remain Targets for Domestic Violence
Men Remain Targets for Domestic Violence
Immigrant Men Remain Targets for Domestic Violence
Child Remain Targets for Domestic Violence
Old People Remain Targets for Domestic Violence
 
 
8. State Domestic Violence Laws
Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
States differ on the type of relationship that qualifies under domestic violence laws.
Most states require the perpetrator and victim to be current or former spouses, living together, or have a child in common.
A significant number of states include current or former dating relationships in domestic violence laws.
Delaware, Montana and South Carolina specifically exclude same-sex relationships in their domestic violence laws.
 
 
9. Domestic violence Statistics:
Strongly Disagree Disagree Neithe Agree nor Disagre Agree Strongly Agree
I'm aware that every 9 seconds in the US a woman is assaulted or beaten.
I'm aware that around the world, at least one in every three women has been beaten, coerced into sex or otherwise abused during her lifetime.
I'm aware that most often, the abuser is a member of her own family.
I'm ware that domestic violence is the leading cause of injury to women—more than car accidents, muggings, and rapes combined.
I'm aware that nearly 1 in 5 teenage girls who have been in a relationship said a boyfriend threatened violence or self-harm if presented with a breakup.
I'm aware that everyday in the US, more than three women are murdered by their husbands or boyfriends.
I'm aware that ninety-two percent of women surveyed listed reducing domestic violence and sexual assault as their top concern.
I'm aware that domestic violence victims lose nearly 8 million days of paid work per year in the US alone—the equivalent of 32,000 full-time jobs.