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Published byEdwina Brooks Modified over 9 years ago
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Do you have a computer at home? YES NO
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If you have a computer at home does your computer have Internet access? YESNONONE OF THE ABOVE
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Do you have access to a computer with Internet at other locations, relatives, public library, neighbors? YESNO
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Do you have access to other devices that allow you Internet access? Kindle Fire, Nook, iPad or other Tablet Video Game Console None of the Above More than one of the above Smart Phone such as iPhone or Android phone
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When you are on the computer or on a internet enabled device, are you supervised by a parent or adult? YESNONONE OF THE ABOVE
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Is your time on the Internet limited? YESNO
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Do you have an email address? YESNO
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Do you have a social media webpage? (MySpace, Facebook) YESNO
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Do your parents or guardians have access to your email and/or social media site? YESNONONE OF THE ABOVE
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Have you ever been cyber-bullied on email or your social media site? YESNO
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Would you know what to do if you were cyber-bullied online? YESNO
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