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Gender?
 
Male
 
Female
 
 
 
Grade?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
 
 
What ethnicity do you identify yourself with?
 
Caucasian
 
African American
 
Asain
 
Latino
 
Native American
 
Middle Eastern
 
Other
 
 
 
Do you have a job?
 
Yes
 
No
 
 
 
If yes, how many hours do you work per week?
   
 
 
 
How many days do you usualy work each week?
   
 
 
 
do you participate in any sports?
 
yes
 
no
 
 
 
If yes, How many days of the week do you spend practicing/ playing sports?
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
 
 
How many hours a week do you spend practicing/playing sports?
   
 
 
 
Do you participate in any extracurricular activities besides sports?
 
Yes
 
No