2013 ELKS QUESTIONAIRE
Recently, your school was chosen to receive a FREE comic book called HARD CHOICES, along with a bookmark, and other materials to the lucky students at your school. This collectible comic book is sponsored by the Elks Drug Awareness Program and distributed by Marvel Custom Solutions (yes, the home of the Avengers and Spider-Man!) Please take a few minutes to tell us what you thought about the HARD CHOICES Comic and Bookmark.
ABOUT THE COMIC BOOK - section A
1
Did you receive the HARD CHOICES comic book in school or read it online?
2
If you received HARD CHOICES in school, did you...? (Please check all that apply.)
3
If you received HARD CHOICES in school or read it online, how much did you like the HARD CHOICES comic book? (Please check only one.)
4
Do you think that the HARD CHOICES comic book did a good job of explaining why it’s important to stay away from drugs and alcohol? (Please only check one.)
5
Did the story start any conversation about drinking if you are under age? (Please check all that apply.)
YesNo
With your classmates or friends?
With your teachers?
With your teachers and classmates
With your parents or grandparents?
With your brothers or sisters?
Another family member, like an Aunt or an Uncle?
6
Do you think the story in HARD CHOICES has prepared you better to handle peer pressure? (Please check only one.)
7
What did you do with your HARD CHOICES Bookmark? (Please check all that apply.)
8
Do you know where to go if you have questions about drugs and alcohol? (Please check all that apply.)
YOUR THOUGHTS ABOUT WHAT THE STORY SAYS – section B
9
Do you think the story shows that bad things can happen if you drink too much? (Please answer only one.)
10
Do you think because everyone else is drinking you have to drink too? (Please check only one.)
11
At your age, do you think drinking beer, wine or other types of alcohol can make you sick or unable to do your best at school, in sports or enjoy your favorite hobbies? (Please check only one.)
DID YOU KNOW -- DID YOU GO...!? section C
12
Have you heard of the Elks before? (Please check only one.)
13
Which of the following have you participated in or have heard of before? (Please check all that apply)
14
Did you know that if you go to the Elks website at www.elkskidzone.org that you can view a digital version of the Hard Choices comic book? (Please check only one.)
15
Do you plan on going to the Elks website at www.elkskidzone.org? (Please check only one.)
16
Would you like to receive (more) FREE comic books/Bookmarks from Marvel? (Please check only one.)
ABOUT YOU! - section D
17
Are you Male or Female?
18
*What grade are you in?
19
What do you consider yourself to be? (Please check only one.)
20
What city and state do you live in?
21
Besides you, how many other people looked at or read your Elks HARD CHOICES comic and bookmark?
I shared with this many people (enter number)...
THANK YOU FOR YOUR TIME!
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