Water Survey
Please enter your lunch id
Your answer
Please rate the order of beverages that you consume on a daily basis. Select ONE beverage for each choice listed below.
First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Sixth Choice
I DO NOT DRINK THIS BEVERAGE
Milk
Water
Juice
Soda
Sports Drinks
Coffee or Tea
What is your primary source of drinking water?
If you carry a reusable water bottle (e.g. Nalgene or Klean Kanteen), do you refill from water fountains at school?
How many time during a typical school day do you refill from the following?
1 time
2 times
3 times
More than 4 times
I do not refill at all
Water fountain at school
Faucet at school
Faucet at home
How many of the following do you buy during a typical week?
0
1-2
3-4
5 or more
Milk
Bottle of water
Can of soda
Bottle of juice
Coffee or Tea
Sports drinks
Please choose the top 2 reasons behind your decision to REFILL your water bottle using water fountains at school:
Required
Please choose the top 2 reasons in your decision to NOT refill your water bottle using water fountains at school:
Required
Which logo do you prefer?
What School do you go to?
What grade are you in?
What gender do you identify with?
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