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1. What is your gender?
 
Male
 
Female
 
 
 
2. Are you currently enrolled as
 
Full-time Student
 
Part-Time Student
 
None of the Above
 
 
 
3. Which race/ethnicity best describes you? (Please choose only one.)
 
American Indian or Alaskan Native
 
Asian / Pacific Islander
 
Black or African American
 
Hispanic American
 
White / Caucasian
 
 
Other
 
 
 
 
4. Which of the following categories best describes your employment status?
 
Full-Time Employment- 32-40 hrs+ per week
 
Part-Time Employment- 1-32 hrs + per week
 
Per-Diem Employment, Temporary, Once in a while
 
None
 
 
 
5. What is your GPA?
 
3.6 - 4.0+
 
3.1 - 3.5
 
2.6 - 3.0
 
2.1 - 2.5
 
2.0 -1.5
 
1.5-0.0
 
 
 
6. When stopping at a Stop Sign, how often do you stop behind the white line?
 
Always
 
Almost Always
 
Sometimes
 
Almost Never
 
Never
 
 
 
7. When driving, how often do you use your turn signals or blinkers when making a turn?
 
Always
 
Almost Always
 
Sometimes
 
Almost Never
 
Never
 
 
 
8. Do you own a cellphone?
 
Yes
 
No
 
 
 
9. How often do you use cellphones or electronic devices while driving?
 
Always
 
Almost Always
 
Sometimes
 
Almost Never
 
Never
 
 
 
10. Do you have any children under 18?
 
Yes
 
No