Adamson University

Chemical Engineering Department

Electives 3: Nuclear Engineering and Energy Audit
Ecological Footprint Calculator Survey Form

Name (Optional): __________________________ Date: ___________________

Course: __________________________________ Yr level: _________________
Age:___________________ Gender:_________________ GWA:___________________

This survey form aims to have an estimate computation of your Carbon Footprint.
Carbon footprint is the sum of all emissions of greenhouse gases like CO2 which were induced by
your activities in a given time frame. This measurement links to your impact to the environment
based on your lifestyle. All data that will be collected from this survey will remain confidential
and will be used for educational purposes only.
Instructions: Check the box for each criteria that corresponds to you current lifestyle.

Transport:
How do you get to school?
Walk or ride bike (1 Point)
Motorcycle (4 Points) Your Score
Car (6 Points)
Bus (8 Points)

What kind of vehicle does your parents drive?

None (0 Point)
Motorcycle only (4 Points) Your Score
Car (6 Points)
SUV, van, trucks (8 Points)
Distance travelled annually by private car
More than 15,000 miles (12 Points)
Between 10,000 and 15,000 miles (10 Points) Your Score
Between 1,000 and 10,000 miles (6 Points)
Less than 1,000 miles (4 Points)
No car miles (0 Points)

Distance travelled annually by public transport

More than 20,000 miles (12 Points)
Between 15,000 and 20,000 miles (10 Points)
Your Score
Between 10,000 and 15,000 miles (6 Points)
Between 1,000 and 10,000 miles (4 Points)
Less than 1,000 miles (2 Points)
No car miles (0 Points)

How Often does someone in your family travel by plane?

Less than once per month (4 Point)
Once per month (8 Points) Your Score
Twice a month (12 Points)
Once or more a week (16 Points)

Holiday Destination
By land (near province) (2 Points) Your Score
By land or air (local) (6 Points)
By land or air (international) (20 Points)
Energy:
What is your average quarterly gas or oil bill?
More than 5000 (8 Points)
Your Score
Between 2,000 and 5,000 (5 Points)
Between 1,000 and 2,000 (3 Points)
Less than 1,000 (1 Points)

What is your average quarterly electric bill?

More than 5000 (10 Points)
Your Score
Between 2,000 and 5,000 (7 Points)
Between 1,000 and 2,000 (5 Points)
Less than 1,000 (1 Points)

From what source does your energy supply come from?

Your Score
Renewable (2 Points)
Non-Renewable (15 Points)

Food/Commodity Consumption:
Are you:
Vegan (2 Points)
Your Score
Vegetarian (4 Points)
Regular meat eater (8 Points)
Heavy meat eater (10 Points)
The main type of food consumed is:
Mostly fresh, locally grown (2 Points) Your Score

Mix of fresh and convenience (6 Points)

Mostly convenience (12 Points)
 How often does your family eat out or order at a restaurant?
Never (0 Points)
Once a month (4 Points) Your Score
Once a week (6 Points)
Twice or more a week (8 Points)

How many carbonated drinks( soda) do you consume?

None (0 Points)
Once a day (4 Points) Your Score
Twice a day (6 Points)
More than twice a day (12 Points)

How many newspapers or magazines do you buy or get delivered each week?
More than 20 (8 Points)
Your Score
Between 10 and 20 (6 Points)
Between 1 and 10 (4 Points)
None (0 Points)

How much furniture and other commodities such as machines, gadgets do you purchase
each year?
More than 7 (10 Points)
Between 5 and 7 (8 Points) Your Score
Between 3 and 5 (6 Points)
Less than 3 (4 Points)
Hardly any, or second hand (2 Points)
House and Garden:
What type of property do you live in?
Large sized house (10 Points)
Your Score
Medium sized house (7 Points)
Small sized house (4 Points)
Flat/Apartment (2 Points)
How many other people live in your household?
No other person (14 Points)
One other person (12 Points)
Two other people (10 Points) Your Score
Three other people (8 Points)
Four other people (6 Points)
Five other people (4 Points)
More than five people (2 Points)
How many children do you have in this household?
No children (0 Points)
One children (3 Points)
Your Score
Two children (6 Points)
Three children (8 Points)
Four children (10 Points)
More than four children (12 Points)
Does anyone in your home own any of the following items (Check all that apply)
T.V (4 Points)
Cell phone (4 Points) Your Score
DVD Player (4 Points)
Washing machine (4 Points)
Refrigerator (4 Points)
 Air Conditioner (4 Points)
Electric fans (4 Points)
Electric Stoves (4 Points)

Domestic Waste and Recycling:

Amount of domestic waste produced each week (A full large bin is approximately 30 kg)
More than 120 kg (50 Points)
Between 90 and 120 kg (40 Points)
Your Score
Between 60 and 90 kg (30 Points)
Between 30 and 60 kg (20 Points)
Between 15 and 30 kg (10 Points)
Less than 15 kg (5 Points)
To dispose of waste, youre going to use up valuable land. So, start this section with 24
points. Do you recycle this following items?
More than 7 (-4 Points)
Between 5 and 7 (-4 Points) Your Score
Between 3 and 5 (-4 Points)
Less than 3 (-4 Points)
Hardly any, or second hand (-4 Points)

Water Consumption:
If you have a dishwasher, how many times do you run it on an average week?
More than 9 times (3 Points)
Your Score
Between 4 and 9 times (2 Points)
Between 1 and 4 times (1 Points)
Not applicable (0 Points)
 If you have a washing machine, how many times do you run it on an average week?
More than 9 times (3 Points)
Your Score
Between 4 and 9 times (2 Points)
Between 1 and 4 times (1 Points)
Not applicable (0 Points)
Leisure/ School
How often do you use computer?
Less than 10 hours a week (3 Points)
10- 15 hours a week (6 Points) Your Score
15-20 hours a week (9 Points)
20-25 hours a week (12 Points)
More than 25 hours a week (15 Points)
How do you usually submit your homework/ requirements?
Paper (8 Points) Your Score
Electronic/Online (4 Points)

What book format or educational reference are you using?

Books (8 Points)
Ebooks (4 Points)
RESULTS:

Your Total Score

Less than 100 Points

- Congratulations! Very little land and resources are needed to support your lifestyle. If
everyone lived like you, then the human existence and the earth would continue to
prosper sustainably. Well done!

100-160 Points
- Your footprint has more of an impact on the Earths resources. This represents the
European average. If everybody lived as you do, we should need an entire extra planet to
support us.

160-220 Points
- Your footprint uses a large share of the Earths resources. It is close to the UK average. If
everyone lived like you, we would need 3 planet Earths just to support us.

More than 220 Points

- Your footprint is close to that of the North American average. If everyone lived like you,
we would need 4 planet Earths just to support us.

THANK YOU VERY MUCH FOR PARTICIPATING ON OUR SURVEY.

HAVE A GOOD DAY AND GOD BLESS YOU

- Electives 3 Students