NC Problem Gambling Program Baseline Gambling Questionnaire

Pre survey for all Stacked Deck students.

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* 1. School or community organization name

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* 2. Today's Date

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* 3. What is your grade level?

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* 4. Stacked Deck Instructor's Name (Your Teacher)

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* 5. Gender

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* 6. What is your age?

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* 7. What is your date of birth?

Date

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* 8. Mother's first name

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* 9. The last TWO digits of your home phone or cell phone number

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* 10. Which best describes your belief about the benefit or harm that gambling has for society?

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* 11. Which of the following is true?

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* 12. How does modern gambling differ from older forms of gambling?

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* 13. In the United States and Canada, which of these is the most popular way to gamble? 

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* 14. Most casinos make most of their money from:

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* 15. Which of the following is least likely to happen to the average person this year?

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* 16. Gambling can become as addictive as drugs or alcohol

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* 17. Which of the following is associated with the highest rates of problem gambling?

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* 18. Which of these is a risk factor for becoming a problem gambler?

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