1) Age:
10 – 12 13 – 15 16 – 18 19 – 21 21 - older
2) Family type:
Two Parent Family Lone Parent Family Other
3) Are Your Parents:
Married Separated Divorced Other
4) Does your family receive child maintenance off mother/father?
Yes No
5) How many holidays do you go on a year?
0 1 2 - 4 more
6) What is the annual income of your household?
20,000 or less 20, 000 – 30, 000 40, 000 +
7) Does your family household have an internet connection?
Yes No
8) How many televisions does your household have?
0 1 – 3 3 – 5 5 +
9) Does your household have a satalite/cable connection?
Yes No
10) Would you say your family is disadvantaged?
Yes No
Thanks
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