Project Rocket Launch Pre-Survey
Questions marked with an asterisk (*) are mandatory.
1

* Your grade level:

6
7
8
2

* About how many cups of fruits and vegetables should kids your age eat each day?

0
1
2
3
4
5
6
3

* How many of fruits and vegetables do YOU eat most days?

0
1
2
3
4
5
6
4

* How much of the grain foods you eat each day should be whole grains? (Note: Examples of grains foods include bread, pasta, tortillas and breakfast cereals. Whole grains are foods that include the entire grain kernel such as whole wheat, oatmeal and brown rice)

25%
50%
75%
All
5

* Of the grain foods you eat, about how much is whole grains most days?

25%
50%
75%
All
6

* How many servings of low-fat or fat-free milk and milk products should kids your age eat each day? (Note: A serving is equal to one cup of milk or yogurt)

0
1
2
3
4
5
6
7

* How many servings of milk and milk products do you eat most days?

0
1
2
3
4
5
6
8

* At least how many minutes of physical activity should kids get each day? (Note: Some examples of physical activity include walking, running, biking, playing team sports, dancing.)

0
10
20
30
40
50
60
9

* How many minutes are you physically active most days?

0
10
20
30
40
50
60
10

* Rate how strongly you agree with the following statements:

1
Strongly Disagree		2
Disagree		3
Agree		4
Strongly Agree		5
Not Sure
I like to try new foods:
I like eating fruits and vegetables:
I like eating whole grain foods:
I like eating milk and milk products:
In the past week, I have eaten fruits and vegetables at school:
In the past week, I have eaten whole grain foods at school:
In the past week, I have eaten milk and milk products at school:
I like being physically active:
11

* I already do the following activities (select all that apply):

 

walking
running
bicylce riding
swimming
playing hockey
roller blading
ice skating
skiing
playing baseball or softball
playing basketball
jumping rope
dancing
gymnastics
playing football
playing volleyball
Please specify other physical activities you participate in: