1. Do you consider yourself: *

2. Is obesity a concern in your community? *

3. Are efforts being made in community schools to improve the nutritional quality? *

4. Are you involved in an effort to improve you/your family's eating habits? *

5. Are you involved in an effort to improve you/your family's physical activities? *

6. I think the primary cause of childhood obesity is due to: *

7. Should schools be permitted to sell soda or "junk food"? *

8. Should physical education be part of school cirriculums throughout all grade levels? *

9. Would you participate in after school/after work group physical activity programs if offered? *

10. If so, which type of activities would you like to participate in? *

11. How would you like to receive information regarding healthy lifestyle guidelines? *