Word-Import - 1

Appendix A

The purpose of this questionnaire is to gather information on texting and driving. The questionnaire will be distributed to different age groups and genders. Please be accurate. The study is confidential, so do not put your name on the questionnaire. Thank you for your participation.

1. Gender: 2. Age: 3. Religious affiliation:

4. Do you know what texting is?

5. Do you text and drive?

6. How often do you text and drive?

7. Did you text and drive before the Texting and Driving Law was implemented?

8. Why do you text and drive? (Check all that apply.)

9. Have you ever been in a wreck in which texting and driving was involved?

10. Do you know someone who has been in a wreck in which texting and driving was involved?