CASAC Youth Drug Use Survey - 2010
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1. Information About You
12%
*
1
. Gender
Gender
Male
Female
*
2
. Ethnic Origin (check all that apply)
Ethnic Origin (check all that apply)
White or Caucasian
Mexican American
Asian or Asian American
Black or African American
Puerto Rican or Other Latin American
Other (please specify)
*
3
. Grade
Grade
6th
7th
8th
9th
10th
11th
12th
4
. School Name
School Name
*
5
. City/Town
City/Town
Avon
Bloomfield
Canton
East Granby
Granby
Farmington
Hartford
Hartland
Newington
Rocky Hill
Simsbury
Suffield
West Hartford
Wethersfield
Windsor
Windsor Locks
Other (please specify)
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