Student Survey

  Please take a few minutes to answer the following questions about Drop the Pop in your school!

  Click here for a print version.

  Thank you!
  1. a) AT SCHOOL – Check off one of these options that is true for you during Drop the Pop:

        I ate/drank more healthy foods at school (such as fruits, vegetables, milk)

        I ate/drank less healthy foods at school

        I ate/drank the same amount of healthy foods at school

  2. b) AT HOME – Check off one of these options that is true for you during Drop the Pop:

        I ate/drank more healthy foods at home (such as fruits, vegetables, milk)

        I ate/drank less healthy foods at home

        I ate/drank the same amount of health foods at home

  3. a) AT SCHOOL – Check off one of these options that is true for you during Drop the Pop:

        I ate/drank more 'junk' food at school (such as pop, chips, chocolate bars, candy)

        I ate/drank less 'junk' food at school

        I ate/drank the same amount of 'junk' food at school

  4. b) AT HOME – Check off one of these options that is true for you during Drop the Pop:

        I ate/drank more 'junk' food at school (such as pop, chips, chocolate bars, candy)

        I ate/drank less 'junk' food at school

        I ate/drank the same amount of 'junk' food at school

  5. Did you ask your parents to buy healthy foods for you to eat at home or school during Drop the Pop?

        Yes    No

  6. To have a healthy body and teeth, what kinds of foods should you drink and eat MORE and LESS OF?

    I should eat MORE: I should eat LESS:

  7. a) What is one thing you learned during Drop the Pop?

       

  8. b) Did this one thing change anything you eat or do?

        Yes    No

  9. What do you think would make Drop the Pop better?

    More healthy drinks/foods available at school

    More Drop the Pop activities

    Different Drop the Pop activities (Give an example)

    More prizes or giveaways

    Different prizes or giveaways (Give an example)

    Other

    Please list if Other:

  Where do you live?

  What school do you go to?

  What grade are you in?

  How old are you?

  Are you: a girl          a boy