Give yourself a code name (example: grrrl):

Select your session 9:00 10:00 11:00 1:00 2:00

Gender: Female Male

Select age 16 17 18 19 20 other

Computer at home? Yes No

Internet access? Yes No

Hours use the computer per week - all uses (games, chat, email, surfing, word processing, research, etc.): 
0  1-5  5-10  10-15   15-20
  20-25  25-30   30-35   35-40  more

Hours use the computer per week for Internet access:
0  1-5   5-10   10-15   15-20
  20-25   25-30   30-35  35-40   more

Use e-mail? Yes No

Rate confidence level with computers: 
zero  some   confident  master

Have you used the Internet to find information? yes no

How many times per month do you use a library? 
0 less than 1   1  2   3  4  5  more

Have you ever written a citation?   yes   no