YouthWEB Survey
This site is yours. Help us Build it!

Give us your ideas by completing our survey, which will show the role of the internet in the lives of young people.

Please answer the following questions to the best of your ability. You may choose to omit any question that you feel uncomfortable answering.
If you have comments, questions or additional information please fill out the comments box at the end of this page or contact BiasHELP at (631) 479-6015 or E-mail:
Do you have your own e-mail account? Yes No
Please enter your e-mail address:
If you have your own web page or site please
enter the address:

Enter your Zip Code:
If other, please specify:
Sexual Orientation
Gender Identity:
How would you classify your internet use?

 Other :
Please specify about how many days and hours per week you surf the net.
How many days per week? How many total hours per week?
Is the use of the internet permitted / encouraged at your school?
Yes    No

Which service do you use to connect to the internet?

America Online
Optimum Online
Suffolk Web 
   Other :

Is your internet use supervised by a parent / guardian, teacher or other adult?

Yes    No    Sometimes

Is there a filtering feature {Something that blocks hate / porn sites}
on the internet where you surf?

Yes   No   Not sure

If yes, which one(s) Safe Surf Net Nanny Cyber Patrol

Other filter used:

What search engines do you prefer?

List other  

What types of sites do you visit? {pick up to 5

Homework Helping
Downloadable Music
Electronic Greetings Service
Sweepstakes, Contests
Online Games
Auction Sites
Entertainment/Sports/TV Stars
Popular Bands
Magazine Sites
Online Meeting Services
Shopping Sites
News Reporting Sites

What are your three favorite sites?
{Include the web address and short description.}

Address: Description:

Address: Description:

Address: Description:

If you enjoy playing games online,
what games do you play?
About how many hours per week do you play?

Do you visit chat rooms?

Yes   No  Sometimes

If yes, what kind do you chat in?
Private Rooms
Romance/Meeting People
Teen Rooms
News/Political Rooms
Local Rooms
Magazine Sites
Do you have an interest in preventing bias crimes and hate-related harassment?
Yes   No   Not sure

Do you have an interest in web design?

Yes    No    Not sure

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Please leave any questions comments or suggestions you may have about YouthWEBOnline.