George Piggott

SURVEY

Interviewee’s name

Age 15 - 20 20 - 30 30 - 40 40 - 50 50 - 60 60 - 70 70 - 80

Gender M F

Ethnicity

Salary 15 - 20 20 - 30 30 - 40 40 - 50 50 - 60 60 - 70 70 - 80

Job Professional Manager Skilled Semi- Unskilled Unwaged Student or

skilled pensioner

Religion

First
letters of
postcode

1. Rate these campaigns in order of value to you:

CAMPAIGN Rating

Drink-driving 1 2 3 4 5

SDI’s 1 2 3 4 5

Anti smoking 1 2 3 4 5

Water aid 1 2 3 4 5

Third world infant mortality 1 2 3 4 5

World Health Organisation 1 2 3 4 5

Drugs awareness 1 2 3 4 5

Police on the streets 1 2 3 4 5

Animal welfare 1 2 3 4 5

2. Do you feel that using a condom is necessary?

Disagree Disagree Don’t know Agree Agree strongly

strongly
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3. Which of these STD’s do you think are dangerous?

HIV/Aids Chlamydia Gonorrhoea Herpes Syphilis Crabs (Pubic

Lice)

Extremely
dangerous

Can be
dangerous

Never
dangerous

4. Which of the following statements do you agree with?

I do not like to talk Agree Agree Don’t know Disagree Disagree

about STD’s strongl somewhat somewhat strongly
y

I am aware of help Agree Agree Don’t know Disagree Disagree

available and how strongl somewhat somewhat strongly
y
to get it.

I feel comfortable Agree Agree Don’t know Disagree Disagree

seeking help from strongl somewhat somewhat strongly
y
a parent/guardian.

I feel that I am Agree Agree Don’t know Disagree Disagree

unlikely to get a strongl somewhat somewhat strongly
y
STD.

I always use a Agree Agree Don’t know Disagree Disagree

condom. strongl somewhat somewhat strongly
y

I feel that STD’s go Agree Agree Don’t know Disagree Disagree

away if ignored. strongl somewhat somewhat strongly
y

5. Which of these things would you like to be doing in ten years time?

Windsurfing in the Raising a family Working in Africa Supporting less Living in Australia Nothing at all
Caribbean privileged people
 George Piggott

6. Rank these websites (1-5: use each number once only please - i.e. once you have chosen 5 for a
site, don’t use that number again. There are ten sites - once the numbers 1 to 5 have been used, the
unranked sites remain unranked).

BBC Cancer RSPCA Water Aid NHS The Greenpea WWF Talk to Child line
Research Conservat ce Frank
ive Party

7. In the last six months, how many sexual partners have you had?

1 2 3 4 5 6+

8. Sexual Intercourse can strengthen a relationship.

Agree Agree Don’t know Disagree Disagree
strongly somewhat somewhat strongly

9. Most times that you engage in sexual intercourse, are you under the influence of alcohol.
Agree Agree Don’t know Disagree Disagree
strongly somewhat somewhat strongly

10. If you were to get pregnant, how likely would you be to keep the baby.
Very More than Don’t know Not very Likely Very Unlikely
Likely Likely

11. I give in to easily to peer pressure.

Agree Agree Don’t know Disagree Disagree
strongly somewhat somewhat strongly

12. Rate these activities from 1 - 6.

Partying Shopping Drinking Taking Meeting Going out

Drugs up with on a date
Friends

12345 12345 12345 12345 12345 12345

13. Rank these human achievements according to how important they are for humanity:
52590345.doc: Samples
Bicycle Mobile Television Nuclear Carbon Lasers Fuel from Aeroplane The God
phones power fibre sugar s plough

12345 12345 12345 12345 12345 12345 12345 12345 12345 12345
George Piggott

14. Rate how important these things are to you.

Food and warmth 1 2 3 4 5

A secure home 1 2 3 4 5
Loving people, and being loved 1 2 3 4 5
Having a good time 1 2 3 4 5
Ensuring that your sexual health is in order 1 2 3 4 5

Thank you for doing our survey.

Finally, please would you write some final comments?

What do you think the human race will achieve in the next hundred years?

If you had to produce a website to support a charity or campaign or political ideal, what
would you choose?