Math 246 Survey

Professor Name:
Semester (eg. Spring 03, Fall 04)

1. What year are you? (FR=1, SO=2, JR =3, SR=4)
2. Are you male or female? (M=1, F=2)
3. What is your height (in inches)?
4. What is your weight (in pounds)?
5. What percent of college students, do you think, smoke?
6. How many siblings do you have?
7. What is your birth order (1=oldest/only, 2=second oldest)?
8. What is the distance in miles between your home town and Eau Claire?
9. What is your current GPA?
10. How many hours of exercise to you typically get each week?
11. On the average, how many hours of television do you watch each week?
12. On the average, how many hours do you use the internet each week?
13. Make up a random whole number between 000 and 999.
14. How many hours per week are you working this semester?
15. Estimate the length of the extended arm of the Statue of Liberty (in feet).
16. How many hours of sleep do you typically get per night?
17. Estimate the number of milligrams of caffeine in a cup of coffee.
18. Give a five-digit code for this form (use at least one number).