Name: _______________________________ (optional) Name: _______________________________ (optional)

Grade and Section: ____________________ Grade and Section: ____________________

DIRECTION: DIRECTION:
Put a check mark (/) on the box that corresponds to your Put a check mark (/) on the box that corresponds to your
answer. answer.
QUESTION: QUESTION:
 How many hours do you sleep every day?  How many hours do you sleep every day?
 8 hours  8 hours
 6 hours  6 hours
 4 hours  4 hours
 Others please specify_______________  Others please specify_______________

Name: _______________________________ (optional) Name: _______________________________ (optional)

Grade and Section: ____________________ Grade and Section: ____________________
DIRECTION: DIRECTION:
Put a check mark (/) on the box that corresponds to your Put a check mark (/) on the box that corresponds to your
answer. answer.
QUESTION: QUESTION:
 How many hours do you sleep every day?  How many hours do you sleep every day?
 8 hours  8 hours
 6 hours  6 hours
 4 hours  4 hours
 Others please specify_______________  Others please specify_______________

Name: _______________________________ (optional) Name: _______________________________ (optional)

Grade and Section: ____________________ Grade and Section: ____________________
DIRECTION: DIRECTION:
Put a check mark (/) on the box that corresponds to your Put a check mark (/) on the box that corresponds to your
answer. answer.
QUESTION: QUESTION:
 How many hours do you sleep every day?  How many hours do you sleep every day?
 8 hours  8 hours
 6 hours  6 hours
 4 hours  4 hours
 Others please specify_______________  Others please specify_______________

Name: _______________________________ (optional) Name: _______________________________ (optional)

Grade and Section: ____________________ Grade and Section: ____________________
DIRECTION: DIRECTION:
Put a check mark (/) on the box that corresponds to your Put a check mark (/) on the box that corresponds to your
answer. answer.
QUESTION: QUESTION:
 How many hours do you sleep every day?  How many hours do you sleep every day?
 8 hours  8 hours
 6 hours  6 hours
 4 hours  4 hours
 Others please specify_______________  Others please specify_______________