High School Survey
Exit this survey >>
1. About yourself
Before you begin, if you would like to complete this survey on-line, go to
www.surveymonkey.com/s.asp?u=567471443034.
Tell us a bit about yourself by entering your answer in the box or clicking on one of the choices
1
. I live in
I live in
Ansonia
Derby
Milford
Orange
Seymour
Shelton
West Haven
Other (please specify)
2
. The school I go to is
The school I go to is
3
. I am in grade
I am in grade
4
. I am
I am
Male
Female
5
. I am
I am
Caucasian
African American
Latino/a
Native American
Hawaiian/Pacific Islander
Asian
Other (please specify)
6
. I have had a prevention lesson in class
I have had a prevention lesson in class
Yes
No
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.