About You
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1. About You
This will give me a picture of Middlesex students as a group, and allow me to tailor my teaching to meet your needs.
1
. 1. How many hours of TV do you watch on an average day?
1. How many hours of TV do you watch on an average day?
none
less than one hour
1-2 hours
more than 2 hours
2
. 2. How many hours do you spend on the computer on an average day? (homework, games, I.M.-ing)
2. How many hours do you spend on the computer on an average day? (homework, games, I.M.-ing)
none
less than an hour
1-2hour
more than 2 hours
3
. 3. Do you have a TV in your room?
3. Do you have a TV in your room?
yes
no
4
. 4. How many nights in an average week do you have a sit-down, home-cooked dinner?
4. How many nights in an average week do you have a sit-down, home-cooked dinner?
never
one night
1-3 nights
4-6 nights
every night
5
. 5. How often do you have fast food/take-out for dinner?
5. How often do you have fast food/take-out for dinner?
once a month
once a week
2-3 times a week
more than 3 times a week
never
6
. 6. What did you have for breakfast today?
6. What did you have for breakfast today?
nothing
cereal
waffles or pancakes
muffin
bagel
eggs
sandwich
juice
milk
Other (please specify)
7
. 7. What do you USUALLY have for breakfast?
7. What do you USUALLY have for breakfast?
nothing
cereal
waffles or pancakes
eggs
muffin
bagel
juice
milk
Other (please specify)
8
. 8. What do you usually have for lunch on a school day?
8. What do you usually have for lunch on a school day?
bag lunch from home
school hot lunch
sandwich
cafeteria "sides" (fries, etc)
salad
pretzel
cookies
water
juice
milk
chips
9
. 9. How much milk do you consume on an average day?
9. How much milk do you consume on an average day?
none
1 glass
2-3 glasses
more than 3 glasses
10
. 11. How often do you participate in VIGOROUS exercise lasting more than 30 minutes?
11. How often do you participate in VIGOROUS exercise lasting more than 30 minutes?
never
1-2 times per week
3-4 times per week
more than 4 times per week
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