Survey to be sent/given out to high school students:

 

                                                                                    

Base your answers on how often you believe the AVERAGE TEENAGER uses the following things.

Activity

Daily

Several times per week

Once a week

Once a month

never

Video Games

 

 

 

 

 

Email

 

 

 

 

 

Internet for Educational Purposes

 

 

 

 

 

Internet for Non-educational Purpose

 

 

 

 

 

Television

 

 

 

 

 

Cell Phones

 

 

 

 

 

Computer other than for internet

 

 

 

 

 

 

 

How much do these things impact a student’s grades?

Activity

Very Negatively

Somewhat Negatively

Not at all

Somewhat Positively

Very Positively

Video Games

 

 

 

 

 

Email

 

 

 

 

 

Internet for Educational Purposes

 

 

 

 

 

Internet for Non-educational Purpose

 

 

 

 

 

Television

 

 

 

 

 

Cell Phones

 

 

 

 

 

Computer other than for internet

 

 

 

 

 

 


 

Demographics:  Please fill in the following information.

 

Gender:          _____male

 

_____female

 

Grade:                        _____9

 

                        _____10

 

                        _____11

 

_____12       

 

Current GPA  _____4.0 or higher  

 

                        _____3.5-3.99

 

                        _____3.0-3.49

 

                        _____2.5-2.99

 

                        _____2.0-2.49

 

                        _____1.5-1.99

 

                        _____1.0-1.49

 

                        _____below 1.0

 

Number of years in DoDDS/DDESS schools:      _____

 

Number of years at Lakenheath:     _____

 

If you are involved in extra curricular activities, please estimate the number of hours over the entire year you participate. _____

 

Sponsors:      Civilian _____                                   Enlisted _____                      Officer _____                         Other_____