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0%
 
1. 
* Your gender
Male Female
 
 
* How old are you?
   
 
 
* How many children do you have and what is their age?
   
 
4. 
* Who lives together with you in your household?
 
Son
 
Alone
 
Daughter
 
Stepfather
 
Grandfather
 
Friend of the opposite sex
 
Girlfriend
 
Stepmother
 
Boyfriend
 
Mother
 
Father
 
Friend of the same sex
 
Other
 
 
Grandmother

 
5. 
* Does your family attend church regularly?
 
yes
 
no
 
yes, but not all the members of the family
 
no, but wish we were
 
6. 
* On average how many hours a day does your family watch television (DVDs and videos included)?
 
About 5-8 hours
 
2-5 hours
 
Up to two hours a day
 
We don't watch TV
 
 
* What are the programs watched the most?
   
 
8. 
* Does television affect your family in a _____________ way?
 
positive
 
negative
 
neutral (doesn't affect)
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