2012 Report Card on the Ethics of American Youth

Thank you for your interest in this nationwide survey of young people.

Please complete this form only if you intend to administer the survey and can do so in spring semester 2012. The numbers that you include below will be the number of surveys that we mail to you.

The information you provide here is confidential and will not be sold, rented, or abused in any way.

Due to demographic considerations, we cannot guarantee that we will be able to include every interested organization in the Report Card survey.

1. Our school would like to participate in the Josephson Institute's 2012 Report Card on the Ethics of American Youth.

Our school would like to participate in the Josephson Institute's 2012 Report Card on the Ethics of American Youth. Yes

2. Please indicate the number of youth in Grades 9-12 who will be taking the survey.

Please indicate the number of youth in Grades 9-12 who will be taking the survey. Total Students:
Athletes:

3. We would like a confidential report comparing our school's aggregate responses with the national results.

We would like a confidential report comparing our school's aggregate responses with the national results. Yes

4. Contact Information

Contact Information First Name:
Last Name:
Title:
School Name:
Email:
Street:
City:
State:
Zip:
School Phone:

5. Indicate your school's type.

Indicate your school's type.

6. Indicate the type of community your school is in.

Indicate the type of community your school is in.