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BASICS Initial Survey

1. Demographics

20% of survey complete.

Please Take 10-15 minutes to fill out this brief initial survey. This information is used to assist your first BASICS session.

Question Title

* 1. Please answer the following demographic questions:

Name:

Sex:

Age (in years):

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* 2. Are you a member of a...

	Yes	No
Fraternity	Fraternity Yes	Fraternity No
Sorority	Sorority Yes	Sorority No
College Athletic team?	College Athletic team? Yes	College Athletic team? No

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* 3. Class Standing:

Freshman

Sophomore

Junior

Senior

Graduate Student

Other

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* 4. Where do you live?

Residential hall on-campus

Sorority or Fraternity House

Off-Campus Residence