Jackson County Program Evaluation Project Year 3, Report 1.pdf
Jackson County Program Evaluation Project Year 3, Report 1.pdf
Jackson County Program Evaluation Project Year 3, Report 1.pdf
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Demographic Characteristics1. What is your current age? _______ 10 or younger_______ 11_______ 12_______ 13_______ 14_______ 15_______ 16_______ 17_______ 18_______ 19 or older2. What grade are you in? _______ 6 th_______ 7 th_______ 8 th_______ 9 th_______ 10 th_______ 11 th_______ 12 th3. Are you a male or female? _______ Male_______ Female4. Which of the following best describesyou?_______ White_______ Arab American_______ Black/African American_______ American Indian/Alaskan Native_______ Asian American_______ Native Hawaiian/Other PacificIslander_______ Hispanic/Latino_______ Other, including mixed ethnicity30-day Use1. On how many occasions during thepast 30 days (if any) have you had atleast one drink of alcohol (glass,bottle or can of beer; glass of wine,liquor or mixed drink)?_______ 0 occasions_______ 1 - 2 occasions_______ 3 - 5 occasions_______ 6 - 9 occasions_______ 10 - 19 occasions_______ 20 - 39 occasions_______ 40 or more occasions<strong>Jackson</strong> <strong>County</strong> GRAA <strong>Evaluation</strong> <strong>Report</strong> 34