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* 1. Please indicate what grade you are in for this school year.

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* 2. When you eat school meals which are you most likely to participate in? (Check all that apply)

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* 3. How often do you eat breakfast at school?

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* 4. If you don't eat breakfast at school, where do you eat breakfast?

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* 5. If you do not eat breakfast at school, please tell us why. (Check all that apply.)

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* 6. How is breakfast served at your school?

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* 7. Please rank your preferred breakfast serving options, with the number 1 being the best option for you.

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* 8. Which of the following items would you MOST LIKE  to see offered for breakfast, whether or not it is currently served in school meals? (Check all that apply.)

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* 9. How often do you eat lunch at school?

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* 10. When you are at school, where do you eat lunch?

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* 11. If you don't eat lunch at school, tell us why. (Check all that apply.)

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* 12. Please rank your lunch serving options with the number 1 being the best option for you.

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* 13. If you bring your lunch from home, please tell us why. (Check all that apply.)

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* 14. If you skip lunch, let us know why. (Check all that apply.)

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* 15. Which of the following items would you most like to see offered for lunch, whether or not it is currently served in school meals? (Check all that apply.)

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* 16. Which of the following types of cuisines would you eat, if they were offered by your school? (Check all that apply.)

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* 17. How do you prefer that food is prepared and/or served? (Check all that apply.)

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* 18. Rate your satisfaction of the school dining experience.

  Very Poor Poor Average Good Very Good N/A
Taste of the food that is served.
Appearance of the food that is served.
Variety of the weekly menu.
Healthy Food Availability.
Ability to customize my food order. (Toppings, Condiments, Spices, Sauces.)
Friendliness of the cafeteria staff.
Cleanliness of the cafeteria.

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* 19. Please rate the following Lifestyle Choice statements as they apply to you.

  Strongly Disagree Disagree Neither Agree or Disagree-Neutral Agree Strongly Agree
I want to eat healthier.
I'm involved in extracurricular activities at school and/or in my community.
I eat fast food often.
I have tried new fruits and/or vegetables at school.
I would try new fruits and/or vegetables if my school offered them at mealtimes.
I prefer to eat at restaurants that have customizable or build-your-own options.
I like to eat smaller portions several times throughout my day.

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* 20. Which of the following things would you be interested in as part of your dining program at school? (Check all that apply.)

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* 21. What else would you like us to know about your dining experience at school?

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