Data
To Parent
Data
Student Data
(Your accurate answers to these questions would be appreciated, by no way
can these questions be linked back to you, so please be honest. Thanks, the
management) #1 Have you ever used alcohol?
(IF YES, answer questions 2-6, IF NO skip to question 7) #2 Explain how
often you partake in the drinking of alcohol?
I have only done it once. |
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Only 3-5 times ever. |
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Once every two months. |
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Once every month. |
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Once every couple of weeks. |
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Once every week. |
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2-3 times a week. |
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3+ times a week. |
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#3 What portion of the week do you drink alcohol?
Only on the weekends. |
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Only on the weekdays. |
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Anytime |
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weekend weekdays |
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whats the difference. |
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Before school |
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in my closet.......alone. |
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#4 What percent of your classmates drink on a regular basis? (i.e. 1+ a
week)
10% |
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20% |
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30% |
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40% |
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50% |
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60% |
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70% |
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80% |
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90% |
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#5 Have you ever been served alcohol by an adult? (i.e. 40+ or a parent of
a friend)
#6 How often and how much drinking constitutes a "drinking
problem" ? (Press and hold down "Ctrl" to select more than one
answer)
Any drinking at all in High School. |
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Only once or twice a month. |
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Once or twice a week. |
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3+ times a week. |
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Both drinking before school and after.
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#7 What percentage of your classmates do you think use alcohol regularly?
%10 |
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%20 |
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%30 |
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%40 |
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%50 |
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%60 |
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%70 |
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%80 |
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%90 |
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#8 Have you ever been present at a party or gathering where alcohol was
served?
#9 How often and how much drinking constitutes a "drinking
problem" ? (Press and hold down "Ctrl" to select more than one
answer)
Any drinking at all in High School. |
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Only once or twice a month. |
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Once or twice a week. |
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3+ times a week. |
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Both drinking before school and after.
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Parent Data
#1 Are you aware of any alcohol consumption by your child?
Yes |
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deffinetely. |
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Yes |
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but I am not really sure. |
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No |
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not really sure. |
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No |
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deffinetely not. |
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#2 What percentage of your childs high school peers do you think drink
alcohol regularly?
%10 |
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%20 |
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%30 |
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%40 |
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%50 |
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%60 |
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%70 |
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%80 |
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%90 |
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#3 Have you ever served alchohol to your child's peers?
#4 How often and how much drinking constitutes a "drinking
problem"?
Any drinking at all in High School. |
|
Only once or twice a month. |
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Once or twice a week. |
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3+ times a week. |
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Both drinking before school and after.
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