SurveyMonkey Powered Online Survey

1. Influences Survey

When I think of what makes me choose and do the things I do, when I think of how I view myself and reflect about my core values and my view of life and the world, I have to wonder about what influences me. Please take this survey with great care and thoughtfulness. Thank you for your time and sharing your opinions. We’re doing this for yours and our discussion and understanding.

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1. Gender:

Male

Female

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2. What grade are you in?

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3. How old are you?

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4. What most influences you? (Choose the top 3 things that influence you the most).

Mother (biological or step, whoever is the most important)

Father (biological or step)

Siblings (brothers or sisters, biological or step)

Grandparents

Other relatives (aunts, uncles, cousins, etc.)

Closest friends (those closest to you and with whom you spend the most time or communicate with the most)

Other peers (classmates, teammates, etc.)

Celebrities (popularized performers and entertainers from any field)

Neighborhood (your community, your immediate neighborhood, streets, park, etc.)

Schools and teachers

Sports and coaches

Music

Job, coworkers and bosses

Doctors, medical workers, counselors

Religious faith (Church, Mosque, or Synagogue, youth group, camps, etc.)

Advertisements (commercial in any form, on screens, billboards, in magazines, etc., all around us everywhere)

Media (movies, TV, radio, magazines, internet, etc.)

Books

Video games

Pornography