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* 1. What grade are you currently in?

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* 2. What is your gender?

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* 3. What is your driving status?

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* 4. Do you text/use a cell phone while driving?

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* 5. Do you wear a seat belt?

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* 6. On average, how many passengers ride in your car?

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* 7. Have you ever lost a friend or family member due to an auto accident?

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* 8. Have you ever been in an auto accident and/or received a traffic/speeding ticket?

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* 9. Do you speed while driving?

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* 10. Have you ever driven after consuming alcohol and/or drugs?

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* 11. Have you ever ridden with anyone after they have consumed alcohol and/or drugs?

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* 12. Do you consider yourself an aggressive driver?

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* 13. Do you always completely stop at stop signs?

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* 14. Do you drive at night?

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* 15. Have you ever done any of the following distractions while driving? Please select ALL that apply:

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* 16. Do you plan to sign our safe driving pledge and correct driving habits that could be harmful to yourself and others?

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