The Survey:

Please read all instructions! I know it's annoying, but it's for the sake of accuracy.

Instructions: Copy the questions into your reply. If you prefer, respond anonymously or e-mail responses to me. Neither your name, nor your specific answers will be published. If you have any questions concerning privacy, feel free to contact me at yreverydayhero@hotmail.com.

Childhood: These questions focus on your life growing up. Approximately from when you were born up to the time you were 12.

1. On average, how many hours did you spend daily watching TV or playing video/computer games between the ages of:

A. 2 and 4 years?

B. 6 and 8 years?

C. 10 and 12 years?

D. Present?

2. Did you have any imaginary friends?

3. Describe her/him/it. Name? Characteristics?

4. What was your favorite toy?

5. Did you play with stuffed animals, dolls, or action figures?

6. Describe your favorite one? Name? Characteristics?

7. Did you play dress up?

8. What did you dress up as most?

9. Did you ever pretend to be a character from a TV show, movie, or video/computer game?

10. Who was it?

11. Did you put on puppet shows, make movies or act out skits?

12. What pets did you have?

13. How did you play with them.

14. What was your favorite:

A. TV show?

B. Movie?

C. Video/computer game?

D. Book?

15. What genre of TV shows was your favorite?

16. How often did you read?

17. How often were you read aloud to?

18. Did you take any lessons? (art, dance, music, etc.)

19. Did you play any sports?

20. With whom did you play the most? (parents, friends, alone...?)

Elaborate if necessary.

21. Comparatively, how much time did you spend playing video/computer games or watching TV versus time spent in "imaginative play" such as daydreaming, playing make believe, creating art, etc.

Present: These questions focus on you at present.

22. What’s your:

A. Age?

B. Gender?

C. Eye Color?

D. Dominant Hand? (Right or left?)

23. Would you consider your vocabulary below average, average, above average, or extensive?

24. What did you score on SAT:

A. Verbals?

B. Math?

25. In which languages are you fluent?

26. Where did you learn these languages?

27. Do you find video/computer games addicting?

28. Do you prefer video/computer games you play alone, or with others?

29. Which television shows do you watch regularly?

30. Which of the following do you do regularly? (Just delete the ones you don’t do.)

Writing, drawing, painting, sculpture, sports, reading, composing music, playing music, listening to music, singing, dancing, cooking, acting, producing videos or plays, other art forms.

31. Are these activities valued in your family?

32. What musical instruments do you play?

33. When did you start?

34. Do you consider yourself:

A. Creative?

B. Artistic?

C. Athletic?

D. Talented (and in what)?

E. Innovative?

F. Witty?

G. Shy?

H. Personable?

I. Talkative?

J. A leader?

K. Aggressive?

L. Organized?

35. With which of the following are you most comfortable?

A large group (10 people), a small group (3 people), one other person, alone.

Elaborate if necessary.

36. How often do you daydream?

Timed response questions. The next two questions you have a set time limit to answer. Use all the time you get, work quickly, and don't go over the time limit. Keep in mind there are no wrong answers.

37. In ONE MINUTE, give me as many uses as you can for the object I give you.

A brick.

38. Take THREE MINUTES to elaborate on this story. You don't have to finish it.

Out behind the big red barn at the edge of the walnut grove is a most magnificent pond shaded by an old oak tree. I'll tell you right now, before it's too late. It belongs to McFeeglebee...

Last Question: This one is optional, but fun. If you feel so inclined, go into “Paint” and illustrate either your story or your feelings after taking this survey then post it here.

Thank you so much for your help!