1. What year are you?
A) First
B) Second
C) Third
D) Fourth
E) Other
2. Are you?
A) Male
B) Female
3. How has your experience with the Office of Judicial Affairs been?
I was treated
A) Fairly
B) Unfairly
4. Which educational program were you sanctioned to?
A) By the Numbers
B) Calling the Shots
C) Back on Track
D) Service Learning
E) Other
5. How many times a week, on average, do you drink?
A) Less than 1
B) 1
C) 2
D) 3
E) 4 or more
6. When you do drink, how many drinks, on average, do you consume in
one evening?
A) 0
B) 1-2
C) 3-5
D) 6-9
E) 10 or more
7. For the last week please fill in all the bubbles that apply:
A) I have blacked out from drinking
B) Drinking has affected my relationship w/others
C) Drinking has affected my academics
D) I drank more than originally intended
E) None of the above
8. For the last week please fill in all the bubbles that apply:
A) I have refused alcohol
B) I have limited my number of drinks
C) I stayed in while my friends drank
D) I have avoided high risk situations regarding alcohol
E) None of the above
Please read the following statements carefully. Each one describes a way that you might (or might not) feel about your drinking. For each statement, fill in one bubble from A to E, to indicate how much you agree or disagree with it right now.