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What is your gender?
 
Male
 
Female
 
 
 
What is your age?
   
 
 
 
The importance granted to physical activities by your parents is
 
None
 
Little
 
Some
 
Much
 
Very Much
 
 
 
Your physical sport situation is
 
I do not practice now have I practiced physical-sport in the past
 
I do not practice now but I used to
 
I practice now but I didn't use to practice
 
I practice now and I also practiced in the past
 
 
Have you done any of the following activities in the past 7 days (last week)? If yes, how many times?
0 1-2 3-4 5-6 7+
Walking for exercise
Bicycling
Jogging or running
Aerobics
Swimming
Dance
Skateboarding
Volleyball
Basketball
Weight Lifting
 
 
While growing up how often did your parents:
Never Somewhat Often Often Very Often Daily
Encourage you to do physical activities or play sports
Do physical activities or play sports with you
Provide transportation so you could do physical activities
Watch you participate in physical activities
 
 
 
The importance granted to physical-sport activities by your parents is:
 
None
 
Little
 
Some
 
Much
 
Very Much
 
 
 
In the last 7 days, what did you normally do in between classes?
 
Sat down (talking, reading, doing school work)
 
Stood or walked around
 
Did a little physical activity
 
Did quite a bit of physical activity
 
Did physical activity most of the time
 
 
 
In the last 7 days, on how many days right after class, did you do activities in which you were very active?
 
None
 
1 time
 
2-3 times
 
4 times
 
5 times
 
 
 
In the last 7 days, how many evenings did you participate in activities in which you were very active?
 
None
 
1 time
 
2-3 times
 
4-5 times
 
6-7 times
 
 
 
On the last weekend how many times did you do physical activities in which you were very active?
 
None
 
1 time
 
2-3 times
 
4-5 times
 
6 or more times
 
 
 
Which one of the following describes you best for the last 7 days?
 
All or most of my free time was spent doing things that involve little physical effort
 
I sometimes(1-2 times last week) did physical activities in my free time
 
I often (3-4 times last week) did physical activities in my free time
 
I quite often (5-6 times last week)did physical activities in my free time
 
I very often (7+ times last week) did physical activities in my free time
 
 
Mark how often you did physical activity for each day last week.
None A little bit Medium Often Very Often
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 
 
 
Were you sick last week, or did anything prevent you from doing your normal physical activities?
 
Yes
 
No
 
 
For each statement check “definitely true” if you are sure it is true about you and “probably true” if you think it is true but are not absolutely certain. Similarly, you should check “definitely false” if you are sure the statement is false and “probably false” is you think it is false but are not absolutely certain.
definitely false probably false probably true definitely true
There are several people that I trust to help solve my problems.
If I needed help fixing an appliance or repairing my car, there is someone who would help me.
Most of my friends are more interesting than I am.
There is someone who takes pride in my accomplishments.
When I feel lonely, there are several people I can talk to.
There is no one that I feel comfortable to talking about intimate personal problems.
I often meet or talk with family or friends.
Most people I know think highly of me.
If I needed a ride to the airport very early in the morning, I would have a hard time finding someone to take me.
I feel like I’m not always included by my circle of friends.
definitely false probably false probably true definitely true
There really is no one who can give me an objective view of how I’m handling my problems.
There are several different people I enjoy spending time with.
I think that my friends feel that I’m not very good at helping them solve their problems.
If I were sick and needed someone (friend, family member, or acquaintance) to take me to the doctor, I would have trouble finding someone.
If I wanted to go on a trip for a day (e.g., to the mountains, beach, or country), I would have a hard time finding someone to go with me.
If I needed a place to stay for a week because of an emergency (for example, water or electricity out in my apartment or house),I could easily find someone who would put me up.
I feel that there is no one I can share my most private worries and fears with.
If I were sick, I could easily find someone to help me with my daily chores.
There is someone I can turn to for advice about handling problems with my family.
I am as good at doing things as most other people are.
definitely false probably false probably true definitely true
If I decide one afternoon that I would like to go to a movie that evening, I could easily find someone to go with me.
When I need suggestions on how to deal with a personal problem, I know someone I can turn to.
If I needed an emergency loan of $100, there is someone (friend, relative, or acquaintance) I could get it from.
In general, people do not have much confidence in me.
Most people I know do not enjoy the same things that I do.
There is someone I could turn to for advice about making career plans or changing my job.
I don’t often get invited to do things with others.
Most of my friends are more successful at making changes in their lives than I am.
If I had to go out of town for a few weeks, it would be difficult to find someone who would look after my house or apartment (the plants, pets, garden, etc.).
There really is no one I can trust to give me good financial advice.
definitely false probably false probably true definitely true
If I wanted to have lunch with someone, I could easily find someone to join me.
I am more satisfied with my life than most people are with theirs.
If I was stranded 10 miles from home, there is someone I could call who would come and get me.
No one I know would throw a birthday party for me.
It would me difficult to find someone who would lend me their car for a few hours.
If a family crisis arose, it would be difficult to find someone who could give me good advice about how to handle it.
I am closer to my friends than most other people are to theirs.
There is at least one person I know whose advice I really trust.
If I needed some help in moving to a new house or apartment, I would have a hard time finding someone to help me.
I have a hard time keeping pace with my friends.
 
 
For each sentence, select the bubble that describes how often it applied to you during the last month. Work quickly, without bothering to check your answers, and be careful to consider only the last month.
Almost never Sometimes Often Usually
You feel rested
You feel that too many demands are being made on you
You are irritable or grouchy
You have too many things to do
You feel lonely or isolated
You find yourself in situations of conflict
You feel you’re doing things you really like
You feel tired
You fear you may not manage to attain your goals
You feel calm
Almost never Sometimes Often Usually
You have too many decisions to make
You feel frustrated
You are full of energy
You feel tense
Your problems seem to be piling up
You feel you’re in a hurry
You feel safe and protected
You have many worries
You are under pressure from other people
You feel discouraged
Almost never Sometimes Often Usually
You enjoy yourself
You are afraid for the future
You feel you’re doing things because you have to not because you want to
You feel criticized or judged
You are lighthearted
You feel mentally exhausted
You have trouble relaxing
You feel loaded down with responsibility
You have enough time for yourself
You feel under pressure from deadlines
 
 
Mark only the life events that have happen to you in the last two weeks.
Check all that apply
Check
Death (family member or friend)
Had alot of tests
Applying to graduate school
It's finals week
Victim of a crime
Assignments in all classes due in the day
Breaking up with boy-/girlfriend
Found out boy-/girlfriend cheated on you
Lots of deadlines to meet
Property stolen
Check
You have a hard upcoming week
Went into a test unprepared
Lost something (especially wallet)
Death of a pet
Did worse than expected on test
Had an interview
Had projects, research papers due
Did badly on a test
Parents getting divorce
Dependent on other people
Check
Having roommate conflicts
Carlbike broke down, flat tire, etc.
Got a traffic ticket
Missed your period and waiting
Coping with addictions
Thoughts about future
Lack of money
Incompetence at Registrar's office
Thought about unfinished work
No sleep
Check
Sick, injury
Had a class presentation
Applying for a job
Fought with boy-/girlfriend
Working while in school
Arguments with friends
Bothered with no family support
Performed poorly at a task
Couldn't finish everything you needed to
Heard bad news
Check
confrontation with an authority figure
Maintaining along distance boy-girlfriend
Crammed for a test
Feel unorganized
Trying to decide on a major
Feel isolated
Parents contrOlling with money
Couldn't find a parking space
Noise disturbed you while trying to study
Someone borrowed something without consent
Check
Had to ask for money
Ran out of ink while printing
Erratic schedule
Can't understand your professor
Trying to get into your major or college
Registration for classes
Stayed up late writing a paper
Someone you expected to call did not
Someone broke a promise
Can't concentrate
Check
Someone did a "pet peeve" of yours
Living with boy-/girlfriend
Felt need for transportation
Bad haircut today
Job requirements changed
No time to eat
Felt some peer pressure
You have a hangover
Problems with your computer
Problems getting home from bar when drunk
Check
Used a fake I D
No sex in a while
Someone cut ahead of you in line
Checkbook didn't balance
Visit from a relative and entertained them
Decision to have sex on your mind
Talked with a professor
Change of environment
Exposed to upsetting TV show, book, etc
Got to class late
Holiday
Sat through a boring class
Favorite sporting team lost
 
 
The following questions will ask you to rate your belief in your ability to succeed in
your education. Respond to each question using a 1 - 100 scale:
Rating
that you will do well in future courses?
in your ability to learn new information?
in completing your homework assignments?
in understanding reading assignments?
in your ability to study notes?
that you will pass your course(s)?
that you will complete your required course for your degree?
ability to work with others on projects?
seek your professors' help during office hours?
that you are in control of your education?
 
 
 
I go out of the way to make others feel good to be around me.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I help others with their self-development.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I help others to understand my visions through the use of images, stories, models.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I ensure others get recognition and/or rewards when they reach their goals.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I let others work in the manner that the want.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I get things done.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I have an ever expanding network of people who trust me.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I provide challenges for my team members to help them grow.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I use simple words to convey to others what we should or could be doing.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I manage others by setting standards that we agree on.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I rarely give direction or guidance to others.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I consistently provide coaching and feedback so that my team members know how they are doing.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
People listen to my ideas and concerns not out of fear, but because of my skills, knowledge, and personality.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I provide an empathic shoulder when others need help.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I help others with new ways of looking at new and complex ideas or concepts.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I ensure poor performers get unpunished.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
As long as things are going smoothly I am satisfied.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
I closely monitor all projects that I am in charge of.
 
rarely
 
sometimes
 
often
 
almost always
 
I prefer not to answer
 
 
 
 
You are taking this survey:
 
before attending orientation
 
while attending orientation
 
after attending orientation
 
not applicable, did not attend orientation
 
I prefer not to answer
 
 
 
 
What year did you graduate?
   
 
 
 
From which type of high school did you graduate? (Select only one.)
 
Public
 
Private, religiously-affiliated
 
Private, independent
 
Home school
 
GED
 
 
 
 
What were most of your high school grades? Select only one
 
A
 
A-
 
B+
 
B
 
B-
 
C+
 
C
 
C- or lower
 
Grade not used
 
 
 
To date, in which of the following math classes
did you earn a passing grade?

Did not take Passed Did not pass I prefer not to answer
Algebra II
Pre-Calculus/Trigonometry
Calculus
Probability or Statistics
 
 
During high school, how many years of the
following subjects did you complete?
1 2 3 4 5 or more I prefer not to answer
English/literature
Math
Science
History/Social Sciences
Foreign Language
 
 
During high school, how many of the following types of classes did you complete?
1 2 3 4 5 or more I prefer not to answer
Advanced Placement(AP)classes
Honors Classes(not AP) taught at your high school
College Courses for credit
 
 
During you last year of high school, about how much reading and writing did you do?
Very Much Quite a bit Some Very little None I prefer not to answer
Assigned reading(ie. textbooks)
Books on your own for personal enjoyment or academic enrichment
Writing shor papers or reports (5 or fewer pages)
Writing longer papers or reports (more than 5 pages)
 
 
 
During your last year of high school, about how many hours did you spend in a typical 7-day week doing each of the following?

a. Preparing for class (studying, homework, rehearsal, etc.)
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
 
b. Working for pay (before or after school, weekends)
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
 
c. Participating in co-curricular activities(arts,clubs,athletics)
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
 
d. Relaxing and socializing
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
During your last year of high school about how often did you do each of the following?
Very often Often Sometimes Never I prefer not to answer
a. Asked questions in class or
contributed to class discussions
b. Made a class presentation
c. Came to class without
completing readings or
assignments
d. Discussed grades or
assignments with a teacher
e. Worked with other students
on projects during class
Very often Often Sometimes Never I prefer not to answer
f. Worked with classmates
outside of class to prepare
class assignments
g. Prepared two or more drafts
of a paper or assignment
before turning it in
h. Had serious conversations with students of a different race or ethnicity than your own
i. Discussed ideas from your
readings or classes with
teachers outside of class
Very often Often Sometimes Never I prefer not to answer
j. Discussed ideas from your readings or classes with others outside of class (students,
family members, etc.)
k. Talked with a counselor,
teacher, or other staff member about college or career plans
l. Had serious conversations with students who are very different from you in terms of their
religious beliefs, political
opinions, or personal values
m. Missed a day of school
 
 
 
Did you take the SAT/or ACT
 
Yes
 
No
 
I prefer not to answer
 
 
 
 
If you took the SAT, please report your composite score to the best of your memory. (possible range is 1-36)
   
 
 
During your high school years, how involved were you in the following activities at your school or elsewhere? 1 meaning not involved, 6 meaning highly involved.
1 2 3 4 5 6 I prefer not to answer
a. Performing or visual arts programs(bands,chorus,theater, art, etc.)
b. Athletic teams (varsity, junior varsity, club sport, etc.)
c. Student government
d. Publications (student newspaper, yearbook, etc.)
e. Academic honor societies
f. Academic clubs (debate, mathematics, science, etc.)
g. Vocational clubs (business, health, technology, etc.)
h. Religious youth groups
i. Community service or volunteer work
 
 
 
Overall how academically challenging was your high school? 1 meaning not challenging, 6 meaning extremely challenging.
 
1
 
2
 
3
 
4
 
5
 
6
 
I prefer not to answer
 
 
 
 
During the coming school year, about how many hours do you think you will spend in a typical 7-day week doing each of the following.
a. Preparing for class
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
 
b. Working for pay on-or-off campus
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
 
c. Participating in co-curricular activities(organizations, campus publications, student government, etc.)
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
 
 
d. Relaxing and socializing
 
0
 
1-5
 
6-10
 
11-15
 
16-20
 
21-25
 
26-30
 
More than 30
 
I prefer not to answer
 
 
 
During the coming school year, about how often do you expect to do each of the following?
Very often Often Sometimes Never I prefer not to answer
a. Ask questions in class or
contribute to class discussions
b. Make a class presentation
c. Work on a paper or project
that requires integrating
ideas or information
from various sources
d. Work with other students on projects during class
e. Work with classmates
outside of class to prepare class assignments
Very often Often Sometimes Never I prefer not to answer
f. Put together ideas or
concepts from different
courses when completing
assignments or during class discussions
g. Discuss grades or
assignments with an
instructor
h. Discuss ideas from your
readings or classes with
faculty members outside of
Very often Often Sometimes Never I prefer not to answer
class
i. Receive prompt feedback
from faculty on your
academic performance
(written or oral)
j. Work with faculty members
on activities other than
coursework (committees,
orientation, student life
activities, etc.)
Very often Often Sometimes Never I prefer not to answer
k. Discuss ideas from your
readings or classes with
others outside of class
(students, family members,
co-workers, etc.)
l. Have serious conversations
with students of a different
race or ethnicity than your
own
m. Try to better understand
Very often Often Sometimes Never I prefer not to answer
someone else’s views by
imagining how an issue looks from his or her perspective
n. Learn something that
changes the way you
understand an issue or idea
o. Have serious conversations
with students who are very
different from you in terms of their religious beliefs, political opinions, or personal values
 
 
During the coming school year, how certain are you that you will do the following? 1 not at all certain, 6 meaning very certain.
1 2 3 4 5 6 I prefer not to answer
a. Study when there
are other interesting things to do
b. Find additional
information for course assignments when you don’t understand the material
c. Participate regularly in course discussions, even when you don’t feel like it
d. Ask instructors for help when you struggle with course assignments
e. Finish something you have started when you encounter challenges
f. Stay positive, even when you do poorly on a test
or assignment
 
 
During the coming school year, how difficult do you expect the following to be. 1 meaning not at all difficult, 6 being very difficult.
1 2 3 4 5 6 I prefer not to answer
a. Learning course material
b. Managing your time
c. Paying college expenses
d. Getting help with school work
e. Making new friends
f. Interacting with faculty
 
 
How prepared are you to do the following in your academic work at this college? 1 meaning not at all, 6 meaning very.
1 2 3 4 5 6 I prefer not to answer
a. Write clearly and effectively
b. Speak clearly and effectively
c. Think critically and analytically
d. Analyze math or quantitative problems
e. Use computing and information technology
f. Work effectively with others
g. Learn effectively on your own
 
 
How important is it to you that your college or university provides each of the following? 1 meaning not important, 6 meaning very important.
1 2 3 4 5 6 I prefer not to answer
a. A challenging academic experience
b. Support to help you succeed academically
c. Opportunities to interact with students from different economic, social, and racial or ethnic backgrounds
d. Assistance coping with your non-academic responsibilities (work, family, etc.)
e. Support to help you thrive socially
f. Opportunities to attend campus events and activities
 
 
About how much of your college expenses(tuition, fees, books, room & board) this year will be provided by each of the following sources?
None Less than half Half or more All or nearly all Do not know I prefer not to answer
a. Scholarships and grants
b. Student loans
c. Parents/family
d. Self (work on-campus or off-campus, savings)
 
 
 
Did you receive a Federal Pell Grant?
 
Yes
 
No
 
Do not know
 
I prefer not to answer
 
 
 
 
What do you expect most of your grades will be at this college during the coming year?
 
A
 
A-
 
B+
 
B
 
B-
 
C+
 
C
 
C- or lower
 
Grades not used
 
 
 
 
Do you intend to graduate for this college?
 
Yes
 
No
 
Uncertain
 
I prefer not to answer
 
 
 
 
What is the highest academic degree that you intend to obtain at this or any college.(Select only one.)
 
Associate’s degree (A.A., A.S., etc.)
 
Bachelor’s degree (B.A., B.S., etc.)
 
Master’s degree (M.A., M.S., etc.)
 
Doctoral degree (Ph.D., M.D., J.D., etc.)
 
Uncertain
 
I prefer not to answer
 
 
 
 
What month are you completing this survey?
   
 
 
 
Do you know what your major will be? If so please state. If not just state none.
   
 
 
 
Are you, or will you be, a full-time student this fall term?
 
Yes
 
No
 
I prefer not to answer
 
 
 
 
How many of your close friends will attend this college during the coming year?
 
None
 
1
 
2
 
3
 
4 or more
 
I prefer not to answer
 
 
 
 
Are you an international student or foreign national?
 
Yes
 
No
 
I prefer not to answer
 
 
 
 
What is your racial or ethnic identification? (Select only one)
 
American Indian or other Native American
 
Asian, Asian American, or Pacific Islander
 
Black or African American
 
White (non-Hispanic)
 
Mexican or Mexican American
 
Puerto Rican
 
Other Hispanic or Latino
 
Multiracial
 
Other
 
I prefer not to respond
 
 
Please indicate whether your parents completed a 4-year college degree.
Completed a 4-year degree Did not complete a 4-year degree Do not know I prefer not to answer
Mother(or guardian)
Father(or guardian)
 
 
 
How far is your home from this college?
 
20 Miles or less
 
21-50
 
51-100
 
101-200
 
201-400
 
More than 400 miles
 
I prefer not to answer
 
 
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