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2005
February
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Hello:
You are invited to participate in my survey for my 2005 Senior Exit Product. In this survey, the participants will be asked to complete a survey that asks questions about certain situations in which they must answer with an honest answer based on there personal, daily life. It will take approximately 10-15 minutes to complete the questionnaire. When you have completed the survey, please turn in your answers to me!
Your participation in this study is completely voluntary, and very much appreciated. Your survey responses will be keep confidential. If you have questions at any time about the survey or the procedures, please feel free to ask me. Thank you very much for your time and support.
How many days a week do you typically eat out?
Never
1-2 Days
3-4 Days
5-7 Days
*
What is your favorite food?
*
Are you active in any sports? If so which ones?
Which of the following fast-food- resturants do you typically visit?
McDonalds, Burger King, Jack-in-the-box
Chick-fil-a, Wendys
KFC, Bojangles
Taco Bell, Arby's
Approximately, how much physical activity do you get per week during school?
15-30 Minutes
1-2 Hours
2-3 Hours
4-5 Hours
How much time do you anticipate you apend infront of either a computer, or television?
Less than 30 minutes
1-2 Hours
3-4 Hours
More than 5 Hours
During a regular school day, which of the following drinks do you consume?
Soda
Water
Gatorade, or Powerade
Fruit Juice
Approximately how much physical activity during school do you get in a week?
About 5 Hours
About 30 minutes
About 2 Hours
About 1-1 1/2 Hours
About 15 minutes
How often do you eat out during the week?
2-3 Days a week
5-7 Days a week
4-5 Days a week
1 Day a week
Of the following Fast-Food Resturants, which one do you often visit?
McDonalds, Burger King
Wendys, Chick-fil-a
Taco Bell, Pizza Hut
KFC,Bojangles
Do you know what the Food Guide Pyramid is? If so what are the 6 Food groups it covers?
Please contact
[email protected]
if you have any questions regarding this survey.
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