1. 15. Have you thought about a career?
___Yes ___No
16. Have you discussed career options with:
Yes No
your
parents/guardians?
a teacher?
a guidance counselor?
your friends?
17. Have you participated in a math or science competition?
___Yes (skip question 19) ___No (skip question 18)
18. If you answered yes to question 17, would you participate in another math or science
competition?
___Yes ___No
19. If you answered no to question 17, would you participate in a math or science
competition in the future?
___Yes ___No
If no, please explain why not: _________________________________________
20. When you think of science, what three words come to mind? Please check up to
three.
___ Cool ___ Interesting
___ Straightforward ___ Nerdy
___ Uninteresting ___ Awesome
___ Exciting ___ Mysterious
___ Boring ___ Difficult
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2. 21. When you think of math, what three words come to mind? Please check up to three.
___ Cool ___ Interesting
___ Straightforward ___ Nerdy
___ Uninteresting ___ Awesome
___ Exciting ___ Mysterious
___ Boring ___ Difficult
22. I am ________.
___an elementary school student
___a junior high school or middle school student
___a high school student
___a high school graduate not currently enrolled in college or technical school
___a college student
___none of the above
23. I am ___Male ___Female
24. My home state/country is ________________________________.
25. What is your mother’s or female guardian’s occupation?
_____________________________
26. What is your father’s or male guardian’s occupation?
_______________________________
27. Please indicate in order of preference your three or four favorite leisure activities.
One ____________________________________________
Two ____________________________________________
Three ____________________________________________
Four ____________________________________________
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3. 28. Please rank the following media by which you use the most with 1 representing the
medium you most use, 2 representing the medium you use second most, etc. If you don’t
use it, don’t rank it.
Smart phone with Internet applications ______
Movies ______
Computer (non-Internet use) ______
Computer (Internet use) ______
Television ______
Radio ______
Newspaper ______
Magazines ______
29. Please indicate if you belong to or use any of the following social media sites. Check
all that apply.
Yes No
Facebook
Twitter
MySpace
YouTube
Blogs
Other
30. If you answered yes to blogs, please list your top three blogs.
One ____________________________
Two ____________________________
Three ____________________________
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4. 31. If you answered yes to Other on question 29, please list the other social media sites
you belong to.
One ____________________________________
Two ____________________________________
Three ____________________________________
Thank you for participating in this survey!
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