Gross National Happiness Survey

Q1. Gender:

Select One: *

Q2. What is your age?

Q3. What Grade are you in?

Other: *

Q4. What languages can you speak?

Untitled *

Q5. Do you consider yourself religious?

Choose One *

Yes No

Q6. Current Employment Status

Other: *

Q7. Household Size (How many people live in your home?)

Your Wellbeing

Q8. List as many things as you can that you think lead to a happy and content life?

Comment *

Q9. On a scale of zero to ten, I consider myself:

Q10. How would you rate the quality of your life?

Select One: *

Q11. How much do you enjoy life?

Select One: *

Q12. How satisfied are you with the following aspects of your life?

Your Health *

Your Standard of Living *

Your current job (if you have one) *

The relationship you have with your immediate family members. *

Local environment *

The balance in my life between work/school/social life *

Q13. Please take a few minutes to think about your life. Do you agree with the following statements?

I have found a satisfactory meaning in life *

I generally feel free to express my ideas and opinions *

Most of the time I feel a sense of accomplishment from what I do *

People in my life care about me *

Q14. ow many people are so close to you that you can count on them if you….

Are Sick *

Have Financial Problems *

Have Emotional Problems *

Q15. During the past year, would you describe your life as -

Select One *

Q16. What are your main sources of stress?

List as many as you can here: *

Q17. Consider the last four weeks of your life and answer the following questions:

Have you been able to concentrate on what you’re doing? *

Have you lost much sleep over worry? *

Have you felt you were playing a useful part in things? *

Have you felt capable of making decisions about things? *

Have you felt constantly under strain? *

Have you felt you couldn't overcome your difficulties? *

Have you been able to enjoy your normal day-to-day activities? *

Have you been able to face up to your problems? *

Have you been feeling unhappy and depressed? *

Have you been losing confidence in yourself? *

Have you been thinking of yourself as a worthless person? *

Have you been feeling reasonably happy, all things considered? *

Q18. How spiritual do you consider yourself to be?

Select One: *

Q19. During the past few weeks, how often have you felt the following moods/emotions?

Anger *

Guilt *

Selfishness *

Jealousy *

Pride *

Calmness *

Empathy / Compassion *

Contentment *

Disappointment *

Sadness *

Frustration *

Fear *

Worry *

Is there an emotion that you feel that is not listed above? *

Health

Q20. In general, would you say your health is:

Select One: *

Q21. Thinking about your physical health, which includes physical illness and injury, how many days during the past 30 days was your physical health NOT good?

# of days: *

Q22. Thinking about your mental health, which includes stress, depression, and problems with emotions, how many days during the past 30 days was your mental health NOT good?

# of days: *

Q23. In your entire life, have you ever consumed alcohol?

Select One: *

Q24. How old were you when you first started drinking?

Age: *

Q25. Have you consumed any type of alcohol during the past 12 months?

Select One: *

Q26. During the past twelve months, how often have you been intoxicated?

Select One: *

Q27. During the past twelve months, how many times have you "blacked out"?

# of times: *

Q28. Are you a regular smoker? (at least one cigarette a day)

Select One: *

How old were you when you started to smoke? *

Q29. Are you a regular smoker of marijuana? (more than once a week)

Select One: *

How old were you when you started to smoke marijuana? *

Historical Literacy

Q30. Do you know the names of at least some of your great-grandparents:

Select One: *

Q31. How would you rate your knowledge and understanding of the following?

Local stories and legends of Waterdown/Flamborough: *

Historical Events of Waterdown/Flamborough: *

Historical Events of Ontario: *

Historical Events of Canada: *

Q32. How would you rate you knowledge and understanding of the following?

The Constitution: *

Canada's system of government: *

The difference between Canada's federal, provincial and municipal governments: *

What your Member of Parliament does: *

What your Member of Provincial Parliament does: *

Ward Councillor: *

Q33. What is your main source of political (news) information?

Other: *

The Natural World and You

Q34. What is your knowledge of the names of plants and wild animals in your area?

Select One: *

Q35. How often to you eat local food? (food grown within 20 km of your home)

Select One *

Education

Q36. In the previous year have you participated in the following extra curricular activites?

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