* 1. What grade are you currently in?

* 2. What activities are you involved in?

* 3. How easy or difficult is it for youth under the age of 21 years to get alcoholic beverages in your community?

* 4. Think back over the last 30 days. On how many days, if any, did you drink one or more drinks of an alcoholic beverage? (Alcoholic beverages include beer, wine, wine coolers, malt beverages, and liquor.)

# of days, 0-30

* 5. How do you feel about someone your age having one or two drinks of an alcoholic beverage nearly every day?

* 6. What percentage of students at your school, do you believe have used alcohol during the past 30 days?

* 7. Have you had more than just a sip of beer, wine, or other alcoholic beverage in the past 30 days?

* 8. If you drank alcohol within the past 30 days, from whom did you get the alcohol?

* 9. There is nothing wrong with people under 21 drinking wine, beer or other alcoholic beverages.

* 10. The typical student at my school believes that there is nothing wrong with people under 21 drinking beer or wine.

* 11. When hanging out or socializing with friends, what do you typically drink

* 12. When hanging out or socializing with friends, what do you think a typical student at your school drinks?

* 13. Would you do any of the following to avoid drinking an alcoholic beverage if you were with other students who were drinking?

  True False
I don't drink alcohol.
I drink alcohol, so I do not try to avoid drinking.
I avoid places and situations where students drink.
I do not hang out with drinkers.
I leave when other students start to drink.
I stay but try to avoid the drinkers.
I tell people “I don’t want to drink” if I am offered alcohol,
I try to get students to stop drinking.
I pretend to be drinking alcohol by holding a beer or other drink.

* 14. Would your parents be upset if they caught you drinking alcohol?

* 15. About how many times during this school year have you seen or heard information based on data collected at your school stating that most students at your school and at other schools like yours do not drink alcohol?

* 16. What other drugs are you concerned about your peers using?

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