[T] 770.962.8396
[F] 770.962.1291
Staff Information

Email Address (OPTIONAL):

Age:

Sex:

Male
Female

ZIP Code where you currently live:

What is your race/ethnicity:

Have you ever used any of the following web sites?
Check all that apply.

Facebook
Myspace
Habbo
hi5
Friendster
Classmates.com
Xanga
YouTube
Flixster
Netlog
iLike
BlackPlanet
MiGente.com
Meetup.com
Sconex
Other:

Which of the following sites did you visit MOST OFTEN
during the past 3 months?
 
YOU MAY SELECT
UP TO 3 MAXIMUM.

Facebook
Myspace
Habbo
hi5
Friendster
Classmates.com
Xanga
YouTube
Flixster
Netlog
iLike
BlackPlanet
MiGente.com
Meetup.com
Sconex

If you own a cell phone, what is the name of your service provider?

I do not have a cell phone
AT&T (Cingular)
TMobile
MetroPCS
Sprint Nextel
Verizon
TracFone
Alltel
Boost Mobile
Virgin Mobile
STI Mobile
Net10

During a normal week, how many
instant messages do you send and receive?

This includes text messages and
multimedia messages sent on your cell phone.

None
1-2
3-4
5-10
11-20
21-30
more than 30

Do you know how to post comments on a web site (like MySpace or Facebook) with graphics included in the comment?

Yes
No

If you have a personal profile on a web site like MySpace, how often do you make changes to it? For example: adding photos, editing your preferences and making changes like arranging the layout.

I do not have a personal profile on a web site.
I do have a profile, and I update it at least every day.
I do have a profile, and I update it at least every week.
I do have a profile, and I update it at least every month.
I do have a profile, and I update it less than once every month.

Do you think young adults in the metro Atlanta would be interested in visiting a web site that has information about HIV/AIDS and STDs for young adults?

Yes
No
Not sure
Why or why not?

How do you connect to the Internet when you go online? Do you go online...

from a library or community center
at an Internet cafe
at school
by using Web TV
by using a cell phone or other device
or, by using a computer someplace else ?
none of the above 

Do you own any of the following devices?

Please check all that apply.

A desktop computer
A laptop computer
A cell phone
A personal digital device like a Sidekick, Palm Pilot or Blackberry
An iPod
An MP3 player (of a different brand than iPod) 

If you go online using a computer at home, what type of Internet connection do you have?

I do not go on the Internet at home
Dial-up telephone line
High-speed DSL-enabled phone line
High-speed Cable modem
High-speed Wireless connection (either land-based or satellite)
High-speed T-1 or fiber optic connection
Other
Don’t know

Do you currently participate in any of the following activities?

Please check all that apply.

A school club like drama or language club
A school sports program
Some other extracurricular activity, like band
A club or sports program that is NOT affiliated with your school, like a church youth group, rec league or volunteer organization in your community

Do you have a part-time job?

Yes
No

How often do you spend time with friends IN PERSON, doing social activities outside of school?

Every day
Several times a week
At least once a week
Less than once a week
Never

How often do you send messages through social networking sites like MySpace or Facebook?

Every day
Several times a week
At least once a week
Less than once a week
Never

Do you ever use a networking web site (like Myspace or Facebook) to do any of the following things?

Please check all that apply.

Make new friends
Stay in touch with friends you see a lot
Stay in touch with friends you rarely see in person
Flirt with someone
Make plans with your friends
Post messages to a friend's page or wall
Send a bulletin or group message to all of your friends
Send private messages to a friend within the social networking system
Wink, poke, give "e-props" or kudos to your friends
Post comments to a friend's blog
 

Finally, please take a moment to visit each of the following web sites.

For each site, please tell us if you like it -- and why.  We want to design our web site to be popular and attractive, based on your input and your suggestions.

www.youthnoise.com
YN is a social networking site for people under the age of 27 who like to connect based on deeper interests than Paris Hilton's wardrobe and want to get engaged within a cause. Find a cause, search for friends, and get involved. Want to free Tibet? Passionate about human rights?

My opinion about this web site:

www.itsyoursexlife.com
This site provides reliable, objective sexual health information for young adults. The It's Your (Sex) Life campaign is part of the Henry J. Kaiser Family Foundation

 

My opinion about this web site:

www.teenwire.com
This site from Planned Parenthood gives great information on young men's and women's bodies, how not to have sex if you don't want it, safer sex, and dealing with breaking up. It also gives referrals to local clinics.

 

My opinion about this web site:

www.sexetc.org
A Web site by teens for teens; this site helps youth become sexually healthy people and avoid pregnancy and disease during their teenage years.

 

My opinion about this web site:

www.scenariosusa.com
This site allows you to watch films—written by and for teens—that address important topics such as relationships, communication, sexual identity, teen pregnancy, and HIV/AIDS.

 

My opinion about this web site:


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