412 Student Survey

Male or Female? *

Male

Female

Are you in middle school or high school? *

Middle School

High School

How often do you drink alcohol? *

Frequently (at least once a week)

Sometimes (at social events)

Rarely (once or twice a year)

I have never drank alcohol.

How often do you smoke weed? *

Frequently (at least once a week)

Sometimes (at social events)

Rarely (once or twice a year)

I have never smoked weed.

How often do you take other illegal drugs? *

Frequently (at least once a week)

Sometimes (at social events)

Rarely (once or twice a year)

I have never taken other illegal drugs.

How often do you send sext messages (picture and/or text)? *

Frequently (at least once a week)

Sometimes (at least once a month)

Rarely (once or twice a year)

I have never sent a sext message.

How often do you receive sext messages (picture and/or text)? *

Frequently (at least once a week)

Sometimes (at least once a month)

Rarely (once or twice a year)

I have never received a sext message.

How often do you look at porn (any form: internet, tv/video, magazine)? *

Frequently (at least once a week)

Sometimes (at least once a month)

Rarely (once or twice a year)

I have never looked at porn.

Have you ever participated in oral sex? *

Yes

Have you ever had sexual intercourse? *

Yes

Have you been sexually active within the last 6 months? *

Yes

Have you ever been involved in homosexual activity? *

Yes

Have you ever had thoughts of suicide? *

Yes

How often does your family eat together as a family? *

Frequently (multiple times a week)

Sometimes (once or twice a month)

Rarely (once or twice a year)

My family never eats together.

How often does your family do activities together? *

Frequently (once a week)

Sometimes (once a month)

Rarely (once or twice a year)

My family never does activities together.

How often do you have a serious/deep conversation with one of your parents? *

Frequently (at least once a week)

Sometimes (at least once a month)

Rarely (once or twice a year)

I never have serious/deep conversations with my parents.

How comfortable are you talking to a parent about issues in your life (sexual temptations, sin struggles, etc)? *

Very comfortable (I can talk to my parents about anything.)

Somewhat comfortable (I can talk to my parents about some things.)

Not comfortable (I can't imagine talking to my parents about my sin struggles.)

How often do you fight with your parents? *

Frequently (at least once a week)

Sometimes (at least once a month)

Rarely (once or twice a year)

I never fight with my parents.

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