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Reach4life Questionnaire
1.
What country/region do you live in?
AD - Andorra
AE - United Arab Emirates
AF - Afghanistan
AG - Antigua and Barbuda
AI - Anguilla
AL - Albania
AM - Armenia
AO - Angola
AQ - Antarctica
AR - Argentina
AS - American Samoa
AT - Austria
AU - Australia
AW - Aruba
AZ - Azerbaijan
BA - Bosnia and Herzegovina
BB - Barbados
BD - Bangladesh
BE - Belgium
BF - Burkina Faso
BG - Bulgaria
BH - Bahrain
BI - Burundi
BJ - Benin
BL - Saint Barthelemy
BM - Bermuda
BN - Brunei
BO - Bolivia
BR - Brazil
BS - Bahamas, The
BT - Bhutan
BV - Bouvet Island
BW - Botswana
BY - Belarus
BZ - Belize
CA - Canada
CC - Cocos (Keeling) Islands
CD - Congo, Democratic Republic of the
CF - Central African Republic
CG - Congo, Republic of the
CH - Switzerland
CI - Cote d'Ivoire
CK - Cook Islands
CL - Chile
CM - Cameroon
CN - China
CO - Colombia
CR - Costa Rica
CU - Cuba
CV - Cape Verde
CW - Curacao
CX - Christmas Island
CY - Cyprus
CZ - Czech Republic
DE - Germany
DJ - Djibouti
DK - Denmark
DM - Dominica
DO - Dominican Republic
DZ - Algeria
EC - Ecuador
EE - Estonia
EG - Egypt
EH - Western Sahara
ER - Eritrea
ES - Spain
ET - Ethiopia
FI - Finland
FJ - Fiji
FK - Falkland Islands (Islas Malvinas)
FM - Micronesia, Federated States of
FO - Faroe Islands
FR - France
FX - France, Metropolitan
GA - Gabon
GB - United Kingdom
GD - Grenada
GE - Georgia
GF - French Guiana
GG - Guernsey
GH - Ghana
GI - Gibraltar
GL - Greenland
GM - Gambia, The
GN - Guinea
GP - Guadeloupe
GQ - Equatorial Guinea
GR - Greece
GS - South Georgia and the Islands
GT - Guatemala
GU - Guam
GW - Guinea-Bissau
GY - Guyana
HK - Hong Kong
HM - Heard Island and McDonald Islands
HN - Honduras
HR - Croatia
HT - Haiti
HU - Hungary
ID - Indonesia
IE - Ireland
IL - Israel
IM - Isle of Man
IN - India
IO - British Indian Ocean Territory
IQ - Iraq
IR - Iran
IS - Iceland
IT - Italy
JE - Jersey
JM - Jamaica
JO - Jordan
JP - Japan
KE - Kenya
KG - Kyrgyzstan
KH - Cambodia
KI - Kiribati
KM - Comoros
KN - Saint Kitts and Nevis
KP - Korea, North
KR - Korea, South
KW - Kuwait
KY - Cayman Islands
KZ - Kazakhstan
LA - Laos
LB - Lebanon
LC - Saint Lucia
LI - Liechtenstein
LK - Sri Lanka
LR - Liberia
LS - Lesotho
LT - Lithuania
LU - Luxembourg
LV - Latvia
LY - Libya
MA - Morocco
MC - Monaco
MD - Moldova
ME - Montenegro
MF - Saint Martin
MG - Madagascar
MH - Marshall Islands
MK - Macedonia
ML - Mali
MM - Burma
MN - Mongolia
MO - Macau
MP - Northern Mariana Islands
MQ - Martinique
MR - Mauritania
MS - Montserrat
MT - Malta
MU - Mauritius
MV - Maldives
MW - Malawi
MX - Mexico
MY - Malaysia
MZ - Mozambique
NA - Namibia
NC - New Caledonia
NE - Niger
NF - Norfolk Island
NG - Nigeria
NI - Nicaragua
NL - Netherlands
NO - Norway
NP - Nepal
NR - Nauru
NU - Niue
NZ - New Zealand
OM - Oman
PA - Panama
PE - Peru
PF - French Polynesia
PG - Papua New Guinea
PH - Philippines
PK - Pakistan
PL - Poland
PM - Saint Pierre and Miquelon
PN - Pitcairn Islands
PR - Puerto Rico
PS - Gaza Strip
PS - West Bank
PT - Portugal
PW - Palau
PY - Paraguay
QA - Qatar
RE - Reunion
RO - Romania
RS - Serbia
RU - Russia
RW - Rwanda
SA - Saudi Arabia
SB - Solomon Islands
SC - Seychelles
SD - Sudan
SE - Sweden
SG - Singapore
SH - Saint Helena, Ascension, and Tristan da Cunha
SI - Slovenia
SJ - Svalbard
SK - Slovakia
SL - Sierra Leone
SM - San Marino
SN - Senegal
SO - Somalia
SR - Suriname
SS - South Sudan
ST - Sao Tome and Principe
SV - El Salvador
SX - Sint Maarten
SY - Syria
SZ - Swaziland
TC - Turks and Caicos Islands
TD - Chad
TF - French Southern and Antarctic Lands
TG - Togo
TH - Thailand
TJ - Tajikistan
TK - Tokelau
TL - Timor-Leste
TM - Turkmenistan
TN - Tunisia
TO - Tonga
TR - Turkey
TT - Trinidad and Tobago
TV - Tuvalu
TW - Taiwan
TZ - Tanzania
UA - Ukraine
UG - Uganda
UM - United States Minor Outlying Islands
US - United States
UY - Uruguay
UZ - Uzbekistan
VA - Holy See (Vatican City)
VC - Saint Vincent and the Grenadines
VE - Venezuela
VG - British Virgin Islands
VI - Virgin Islands
VN - Vietnam
VU - Vanuatu
WF - Wallis and Futuna
WS - Samoa
XK - Kosovo
YE - Yemen
YT - Mayotte
ZA - South Africa
ZM - Zambia
ZW - Zimbabwe
2.
What is your sex?
Male
Female
Other
Prefer not to say
3.
What is your age?
Under 13
13 to 15
16 to 19
20 to 25
Over 25
4.
Which race/ethnicity best describes you? (Please choose only one.)
Asian
Black/African/Caribbean
White
Hispanic
Multiple ethnicity / Other (please specify)
5.
What is the highest level of education you have completed?
Primary/Elementary School
Secondary/High School (including relevant exams)
Diploma/Certificate of Higher Education
Undergraduate University/College Degree
Post-Graduate Degree
6.
Do you live in an urban (city or town) or rural (countryside) area
Urban
Rural
7.
What is your current religion, if any?
Christian - Protestant
Christian - Catholic
Mormon
Greek or Russian Orthodox
Jewish
Muslim
Buddhist
Hindu
Atheist or agnostic
Nothing in particular
Other
8.
Did you attend a church or place of worship in the last month?
Yes
No
9.
Would you describe yourself as a Evangelical Christian?
Yes
No
Not Sure
10.
What do you think are the top 3 issues or problems facing your age group?
Addictions/Substance Misuse
Friendships
Family/Parents
Relationships/Sexual Activity
Mental Health
Gender/Sexual Identity
Violence/Crime
Personal Safety
Education/Career Opportunities
Peer Pressure
Money
Online Safety
Pornography
Sexual Health and Pregnancy
Sexual or domestic violence
Bullying
Purpose of life
Other (please specify)
11.
Please tell us more about each of these? What are the main challenges and struggles related to these issues?
1.
2.
3.
12.
For each of these issues/problems, what questions do you have that you would like to have answered?
1.
2.
3.
13.
What are the top 3 high- risk behaviours facing your age group?
Drug/Alcohol Misuse
Crime
Sexual Activity
Online Activity
Pornography
Gambling
Other (please specify)
14.
Please tell us more about each of these? What are the main challenges and struggles related to the issues?
1.
2.
3.
15.
What are the top 3 things you wish you could talk about openly and be guided on by someone you trust?
1.
2.
3.
16.
Please tell us more about each of these? What are the main challenges and struggles related to the issues?
1.
2.
3.
17.
Is there anything else you would like to share having completed the questions?
Current Progress,
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