Please answer the following questions honestly. Individual responses will kept confidential - PLEASE DO NOT PROVIDE YOUR NAME! This information will be used for statistical purposes in a Chimes special report on alcohol consumption among Calvin students. Please consider these questions as they apply to your experience as a Calvin student.

Circle one: Male Female
Do you live off-campus or on-campus? Circle one: Off On
What year are you?
What is your cumulative GPA at Calvin?

1. Do you keep or have you kept alcohol in your dorm room/K.E. apartment?
a) At least 1x/week b) At least 1x/month c) several times a semester d) once e) never

2. Have you ever drank alcohol on campus?
a) yes b) no

3. If you answered YES to the above question, approximately how often?
a) often b) occasionally c) seldom d) just once or twice

4. Are you of legal drinking age in Michigan?
a) yes b) no

5. Have you ever come back to campus legally drunk?
a) yes b) no

6. How often do you go off-campus for the purpose of drinking?
a) both during the week and on the weekend b) every weekend c) once a month
d) less than once a semester e) never

7. Have you ever used a fake I.D. for the purpose of purchasing alcohol?
a) yes b) no

8. How many drinks do you typically have during one night out? (A drink is defined as ONE 12-oz beer, ONE shot of spirits, or 6-oz of wine.)
__________ drinks.

9. When do you drink alcohol?
a) during the week and weekend b) only the weekend c) "special" occasions d) never

10. Do you think drinking alcohol on-campus should merit a fine?
a) yes b) no

11. If you answered YES to the above how much do you think a fine should be?
a) $25 or under b) $25-$50 c) over $50



12. What prompts most of your drinking?(choose ONE)
a) stress b) want to celebrate c) just feel like it d) want to get drunk
e) social event (i.e., Christmas dinner) f) la-dee-da-dee, we's like's to pah-tee.
g) other


Please add any additional comments below. If Chimes may use your comments in an upcoming article, please check here: o Otherwise, all comments will be kept confidential. Again, PLEASE do NOT provide your name. We really don't want to know who you are, just what you as a Calvin student think. Thank you for your cooperation and your participation.