* 1. What elementary school do you attend?

* 2. How old are you?

* 3. Are you male or female?

* 4. What grade are you in?

* 5. Do you eat breakfast every morning?

* 6. When you ride in a car, do you wear a seat belt?

* 7. When you ride a bicycle, do you wear a helmet?

* 8. Are you happy to be at this school?

* 9. Do the teachers and other grown-ups at school tell you when you do a good job?

* 10. Do the teachers and other grown-ups at school listen when you have something to say?

* 11. Do you do things to be helpful at school?

* 12. During the past year, how many times have you hit or pushed other kids at school when you were not playing around?

* 13. Do other kids hit or push you at school when they are not just playing around?

* 14. Do other kids at school spread mean rumors or lies about you on the internet (I.E. Facebook, MySpace, email, instant message)?

* 15. Do you feel safe at school?

* 16. Do you feel safe outside of school?

* 17. Do you try to do your best?

* 18. Do you think you are underweight, about right, or overweight?

* 19. Have other kids at school ever teased you about what your body looks like?

* 20. How many days each week do you exercise, dance, or play sports?

* 21. Yesterday, how much time did you spend watching TV or playing video games?

* 22. On most school days, do you...

* 23. On average, how would you rate the lunch from the school cafeteria?

* 24. How would you improve the school lunch meals?

* 25. Did you understand the questions on this survey?

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