Pre-Program Survey: Driving Habits Questionaire

Think about your experiences driving or when you have driven in a car with your parent or guardian. Answer the following anonymous questions and share how you feel or about your experiences driving or riding in a car.

Please be honest. Your experiences are important for research purposes. YOUR ANSWERS ARE 100% ANONYMOUS and CONFIDENTIAL. Your identity is not attached to your responses in any way.

Question Title

* 1. Please provide the following information.

School:

City/Town:

State:

Current Year:

Question Title

* 2. What is your age?

15 or younger

18 or older

Question Title

* 3. What is your year in school?

Freshman

Sophomore

Junior

Senior

Question Title

* 4. Gender:

Male

Female

Non-Binary

33% of survey complete.