| Name | 
			 
 | Date | 
			 | 
| City | 
			 
 | Group Time | 
			 | 
Gifts for Children (Parents and Legal Guardians)
Please think about children ages 7-12 when answering the following questions.
(Please select as many as apply)
| My own children | □ | 
| Other children in my family | □ | 
| My friends’ children | □ | 
| My children’s friends | □ | 
| Other Please Specify: _______________________________ | □ | 
| None of the above | 
(Please select as many as apply)
| Birthdays | □ | 
| Holidays Please specify: ________________________________________________________ | □ | 
| Other Please specify: __________________________________________________________ | □ | 
| (Please select one response per column) | For children in my family | For children not in my family | 
| $10 or less |  |  | 
| $11-$25 |  |  | 
| $26-$40 |  |  | 
| More than $40 |  |  | 
| In person, in a store | Online | 
|  |  | 
 
CONTINUE 
| 
			 
 
 
 
 | 
(Please select one)
| Educational value |  | 
| Looks fun/Will make child happy |  | 
| Reflects child’s interests |  | 
| Good quality |  | 
| Other Please specify: __________________________ |  | 
Q6. How often do you use the following social media platforms?
| 
				 | Never | Once a week | 2-5 times a week | Every day | 
|  |  |  |  | |
|  |  |  |  | |
|  |  |  |  | |
|  |  |  |  | |
|  |  |  |  | |
| Snapchat |  |  |  |  | 
| Google Plus+ |  |  |  |  | 
| Tumblr |  |  |  |  | 
|  |  |  |  | |
| Other (please specify) ___________________________ |  |  |  |  | 
| Other (please specify) ___________________________ | 
				 | 
				 | 
				 | 
				 | 
| 
				 | Less than once a week | Once a week | 2-5 times a week | Every day | 
| 1. ___________________________________________ |  |  |  |  | 
| 2. ___________________________________________ |  |  |  |  | 
| 3. ___________________________________________ |  |  |  |  | 
| 4. ___________________________________________ |  |  |  |  | 
| 5. ___________________________________________ |  |  |  |  | 
(Please select one)
| Extremely Easy | Somewhat Easy | Neither easy nor challenging | Somewhat Challenging | Extremely Challenging | ||||
|  |  |  |  |  | ||||
| 
			 
 
 
 
 | 
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Christopher Dunn | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-21 |