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Demarest Fall 2015

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Ironwill Kids PowerUp! Survey “Tell Us Your Story!”PRE-Survey

Are you a:

Girl

Boy

What grade are you in?*

1. What is a healthy eater? (Check all that you agree with)*

Someone who reads food labels

Someone who eats lots of fruits and vegetables

Someone who cuts back on junk food, like chips, cookies and candy

Someone who is a breakfast eater

2. What drinks do you usually choose? (Check all the ones that you usually pick)*

Soda

Sports drinks/juices

Milk

Water

3. How likely are you to eat a fruit as a snack?*

Never

Sometimes

Often

4. How likely are you to eat a vegetable as a snack?*

Never

Sometimes

Often

5. How many times in a day do you eat fruits and vegetables?*

Never

1

2 or 3

4 or more

6. When you do eat fruits or vegetables, where do you usually eat them? (Check all that you do).*

At home

At school

At my friend's house

Don't really eat them

7. If you don’t eat fruits and vegetables often, what is the reason? (Check all the ones you agree with).

Don't like the taste

My family doesn't buy them

They cost too much

My friends don’t eat them

8. Are you an “adventurous eater” and willing to try new foods?*

No – I just eat the same things all the time

Not really – only if my family makes me try them

Sometimes – if I like how it looks and smells

Yes – I love trying new foods

9. How many days a week do you eat breakfast?*

Never: I’m not a breakfast eater!

Hardly ever: 1 - 2 days a week

Sometimes: 3 - 4 days a week

Most of the time: 5 - 7 days a week

10. Would you ever be willing to swap out a junk food snack for a healthier one, like fruit?*

Never – junk food is my favorite!

Sometimes – I’d be willing to try

Yes! I’m a healthy eater

I really don’t know

11. How often do you think about what’s in your food before you eat it?*

Never

Sometimes

Most of the time

12. How do you like to eat vegetables, like carrots and spinach? (Check all that you do)*

Yuck! I hate vegetables

Cut up or in a salad

Cooked, as a side dish

Blended in a smoothie

Your survey has been submitted

Thank you for giving your answers

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Posted on October 13, 2015October 13, 2015Author adminCategories Pre-survey

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