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Gender:
 
Male
 
Female
 
 

Age Range:
 
under 12
 
13-17
 
18-35
 
36-45
 
46-65
 
65+
 
 

If you have or currently are attending college, which category does your major fall under?
 
Did not attend
 
Plan to attend
 
Liberal Arts
 
Social Sciences
 
Physical Sciences
 
Business
 
Mathematics
 
Computer Science/IS/IT
 
Other
 

 
 

Do you have:
 
PC with NO Internet access
 
PC with Dial-up connection
 
PC with Broadband: DSL/Cable
 
I do not own a PC
 
 

Do you use the internet as a form of entertainment?
 
Yes
 
No
 
 

Do you use the internet to communicate with (Check all that applies):
 
Friends
 
Relatives
 
Co-workers
 
Online Friends
 
I do not use the Internet to communicate with people
 
Other
 

 
 
 
What is your PRIMARY use of the Internet?
   
 
 
 
Do you think the Internet has led to Social Isolation? Yes or No?
   
Why?
   
 
 
 
9. Do you think the internet has led to greater human interaction? Yes or No?
   
Why?
   
 
 

10. If Internet access was destroyed, what effect would it have on your life?
No effect Little effect Moderate effect Great effect Profound effect
 
 

If you own a cell phone, do you (check all that apply):
 
Communication
 
Access the Internet
 
Use text messaging
 
I do not own a cell phone

 
 
 
Any other comments?
   
 
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