センサス@スクール | sample page [CensusAtSchool - Japan]

CensusAtSchool 2009 Questionnaire

IMPORTANT MESSAGE: This is a sample of the 2009 CensusAtSchool questionnaire. All questions, layout and format are exactly the same as the live questionnaire. However you will not be able to submit your responses to the questions. If you want your resposes to be part of the 2009 database, you must access the live questionnaire and submit your responses. This sample versions is provided to enable you to preview the questions before assigning the questionnaire to youyr students.

Introductions

Welcome to the CensusAtSchool questionnaire, a series of questions about you and your interests.

Please note that the privacy of your responses is respected:

  • your name is not collected, and
  • no form of personal identifier will be stored with your responses to this questionnaire.

If you submit your responses they will become part of a database that will be used by other students and teachers for educational purposes only.

Note on the reply to the questionnaire

  • Please complete all questions.
  • You will need a measuring tape to complete the measurement section within the questionnaire.
  • You must complete the questionnaire in one session. If you exit the questionnaire before you click the submit button all your responses will be lost. You may begin the questionnaire again the next time you Login.
  • When you have finished, read the statement at the end of the questionnaire and click on the Submit button to send your answers to the CensusAtSchool database.

International common question This symbol denotes that the question is an international common question. These common questions are also included in the CensusAtSchool questionnaire of United Kingdom, New Zealand and Canada.

Questionnaire

Enjoy the questionnaire.

A. YOUR PERSONAL DETAILS

1. Are you
2. When were you born? year  Month  Day 
3. What is your blood type?
4. Where are you live in?

B. ABOUT YOU

5. Are you right-handed, left-handed or ambidextrous?
6. Use your DOMINANT HAND to test your reaction time.

Press the Start button. As soon as you see a symbol appear in the box, Click Stop.

     seconds

* This question requires the use of a mouse and the ability to recognise a symbol. If you are unable to do this please skip to question 7.

7. How many hours of sleep do you usually get?

Use the slider to select the number of hours.

 
(a) When you have school the next day?
  hours
(b) When you don't have school the next day?
  hours

* This question requires the use of a mouse. If you are unable to do this please skip to question 8.

C. YOUR MEASUREMENTS

8. How tall are you without your shoes on?

Answer to the nearest half centimetre

. cm
9. When you are standing, what is the height of your belly button above the floor? . cm
10. "What is your arm span?
(Open arms wide, measure distance across your back from tip of right hand middle finger
to tip of left hand middle finger)
. cm
11. What is the length of your right foot, without a shoe? . cm

D. YOUR SCHOOL

12. "What is the postcode of your school?

Enter the postcode of your school in the space below. If you are unsure ask your teacher

13. Is your school for all boys, all girls or boys and girls?
14. How many students go to your school?

If you are unsure ask your teacher

15. What Year level are you in at school?
16. "What is the main method of travel that you usually use to get to school?
17. How long does it usually take you to travel to school?

Answer to the nearest minute.

E. YOUR LIFESTYLE

18. What did you have for breakfast this morning?

You can select all that apply from the list

19. "Please choose your characteristics from following list. (Multiple Choice)

You can select all that apply from the list

20. Complete the following concentration exercise.
Uncover all the blocks by successfully matching the image pairs.

Click the Start button below to start a new game whenever you want.

* This question requires the use of a mouse and the ability to recognise multiple images. If you are unable to do this please skip to question 21.

21. In what sport or activity do you most enjoy participating?

F. YOUR OPINION

22. "How important are the following environmental issues to you?

Use the slider to mark the level of importance.

Environmental Problem  
Reducing pollution
Recycling our rubbish
Conserving water
Conserving energy (electricity, gas, oil, for heating, lighting, car travel)

* This question requires the use of a mouse. If you are unable to do this please skip this one.

You cannot send the answer because this is sample page.