1. Are you:

male
female

2. How old are you?

 years

3. How long have you lived in New Zealand?

 years

4. Which ethnic group do you belong to?

New Zealand European
Māori
Pacific Island
Asian
Indian
Other

5. What is your height in centimetres?

 cm

6. What is the length of your right foot?

 cm

7. What is the length of your arm span?

 cm

8. What is the circumference of your:

9. Including yourself, how many people live in your household?

10. Think about one adult who you look up to. Which one of the following best describes that adult?

family member
celebrity, such as actor, singer or musician
sportsperson
coach or club leader
business person
someone in my church or religious group
politician
teacher
doctor
other

11. What was the main way you travelled to school today?

walk
motor vehicle
bus
train
bike
other

12. How many minutes did it take you to travel to school today?

10 minutes or less
10 – 20 minutes
20 – 30 minutes
half an hour or longer

13. At school last week, what did you do most of the time at lunchtime?

sat down
stood around
walked around
ran around or played

14. Where did you get your lunch from today?

from home
from a shop on the way to school
from the school shop
from a friend at school
provided by my school
don’t have any

15. How fast is your reaction time? Click on the green button. When it turns red, click it as fast as you can.

16. What did you do yesterday? Write the number of hours you spent doing each activity. Remember the total should be 24.

17. Have you been in a school/club sports team this year?

Yes, for these sports:
No

18. When was the last time you read a book for enjoyment (not for school work)?

I’m reading one now
Quite recently (less than a month ago)
A while ago (but some time this year)
A long time ago (last year or earlier)
I can’t remember

19. Which of the following writing activities have you done for enjoyment (not for school work) over the last month or so? You can choose more than one.

letter/email/txt/msn messenger to a friend
diary/journal/blog
made up story
song lyrics/poem/play
essay/article
none of the above

20. Which of the following do you have? (You may tick more than one)

your own cell phone
your own TV
your own MP3 player e.g. iPod
access to the internet at home
access to a game console e.g. PlayStation, Xbox, Nintendo
none of these

20 a. How many txt messages did you send yesterday?

20 b. About how much do you spend on your cell phone each month?

$ 

20 c. Where does the money come from for your cell phone bill?

my parents or caregivers
my pocket money
my part-time job
other

21. What did you have for breakfast today? You may tick more than one.

water
milk
hot drink
fruit juice
cordial
fizzy drink
toast or bread
cereal or porridge
fruit
cooked food e.g. eggs
dairy food or yoghurt
rice or noodles
other
nothing

22. What did you drink yesterday? Write the number of glasses/cups beside each type of drink

23. What time did you go to bed last night?

24. If Christmas was tomorrow what one present would you most like to get?