Dollars and Sense - Survey - Beginning of Semester

This survey will be completed by students, printed and taken home for parent discussion and signature. The purpose of this survey is to open up conversations about the importance of budgeting.
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Name: 


A red asterisk (*) indicates required questions.

  1. My parent's money is the ONLY source of money I have.*
    Yes
    No


  1. I have a part time job. (less than 40 hours per week)*
    Yes
    No


  1. I have a full time job. (40+ hours per week)*
    Yes
    No


  1. I receive an allowance from my parents.*
    Yes
    No


  1. I have a checking account.*
    Yes
    No


  1. I have a savings account.*
    Yes
    No


  1. I help with the expenses of my housing.*
    I pay rent to my parents.
    I pay the electric bill.
    I pay the gas bill.
    I pay the trash bill.
    I pay the cable bill.
    I pay the Internet bill.
    I pay for maintenance and repairs on our home.
    My parents pay for all expenses associated to our home.
    I am presently living with friends.


  1. I help with my car expenses in the following ways.*
    I make the payments on my car.
    I pay for the insurance on my car.
    I pay for the gasoline.
    I pay for the repairs and maintenance.
    My parents pay for all expenses related to my car.
    I do not have a car.


  1. I help with the expense of my cell phone in the following ways.*
    I pay my own cell phone bill.
    I pay the data plan on my cell phone bill.
    I pay for the overages on my cell phone bill.
    I pay for the apps I add to my phone.
    My parents pay for all expenses associated to my cell phone.
    I do not have a cell phone.


  1. I help with the expense of my medical bills in the following ways.*
    I pay for my own health insurance.
    I pay the co-pay when visiting the doctor.
    I pay the portion of the bill the insurance does not cover.
    I pay the co-pay on my prescriptions.
    My parents pay for all expenses associated to health insurance and medical expenses.
    I do not have health insurance.


  1. I help with the expense of my dental bills in the following ways.*
    I pay for my own dental insurance.
    I pay the co-pay when visiting the dentist.
    I pay the portion of the bill the insurance does not cover.
    My parents pay for all expenses associated to dental insurance and dental expenses.
    I do not have dental insurance.


  1. I help with the expense of my vision bills in the following ways.*
    I pay for my own vision insurance.
    I pay the co-pay when visiting the eye doctor.
    I pay the portion of the bill the insurance does not cover.
    My parents pay for all expenses associated to vision insurance and vision expenses.
    I do not have vision insurance.


  1. I help with my entertainment expenses in the following ways.*
    I pay for my own meals when I eat out without parents.
    I pay for my own movie tickets when not accompanied by parents.
    I purchase my own video games.
    I pay for my own concert tickets when not accompanied by parents.
    My parents pay for all expenses associated to my entertainment.
    I sometimes pay for my entertainment expenses, but my parents pay for the majority of my entertainment expenses.


  1. When I NEED new clothes, shoes, accessories . . . *
    I must pay for them.
    My parents pay for them.
    My parent/grandparent makes them.


  1. When I WANT new clothes, shoes, accessories . . .*
    I must pay for them.
    My parents pay for them.
    My parent/grandparent makes them.


  1. I help with the expenses associated to grooming and hygiene in the following ways. *
    I purchase my own grooming and hygiene supplies.
    I pay for my own haircuts.
    I pay to have my hair color, highlights, lowlights etc.
    I pay for my own manicures/pedicures.
    My parents pay for all expenses associated to grooming and hygiene.
    I sometimes pay for grooming and hygiene expenses, but my parents pay for the majority of these expenses.


  1. I help with the expense of consumables in our home in the following ways.*
    I help pay for food and drinks.
    I help pay for paper products. (toilet paper, paper towels, etc.)
    I help pay for cleaning supplies.
    I help pay for technology consumables (paper, ink, CDs, light bulbs, etc.)
    I help pay for cooking and baking supplies. (cookware, bakeware, etc.)
    I help pay for serving supplies. (plates/bowls, flatware, serving dishes, etc.)
    I help pay for bed/bath supplies. (Sheets, blankets, pillows, towels, etc.)
    My parents pay for all expenses associated to household consumables.
    I sometimes pay for household consumables, but my parents pay for the majority of these expenses.


  1. When shopping for new clothes, shoes, and accessories, I usually make my purchases at . . .*
    Department Stores (Macys, Dillards, JC Penny, etc.)
    Clothing Stores (Abercombie, Urban Outfitters, Gap, etc.)
    Upscale Boutiques (Cache, Black and White, etc.)
    Sporting Goods Stores (Academy, Sports Authority, etc.)
    Re-Sell Shops
    Thrift shops
    Craigslist, EBAY, Facebook -Buy, Barter and Sell





Mrs. Murray
Teacher - BIM and Dollars and Sense
Magnolia High School
TX