Hello my name is Shante¹ and I am on the web for my 8th grade science
project. My research paper is about women and their feelings about
themselves. None of the information I am requesting will ever be used
for anything except my science project. Your name will never be stated
and never will be asked for. I will be graphing the results I get from
the survey to add with my report. Since I am trying to get an accurate
survey completed, please be honest. It would be appreciated if you
would fill out this survey and return it to me via my mom¹s email at
katherine.m.younker at jpl.nasa.gov by Friday, March 8, 1996.
Your time and cooperation is greatly appreciated. Thank you.
GETTING TO KNOW YOU
1. Age range:
______ 12 - 15
______ 16 - 20
______ 21 - 30
______ 31 - 40
______ 41 - 50
2. Ethnic group:
______ African American
______ Native American
______ European American
______ Other _______________
______ under 100 lbs
______ 100 - 125 lbs
______ 125 - 150 lbs
______ 150 - 200 lbs
______ 200 - 225 lbs
______ 225 - 250 lbs
______ 250+ lbs
4. What color eyes do you have?
5. What color hair do you have?
6. Tell three aspects you like and three aspects you don¹t like about
7. Describe your feelings about your body?
8. How do you feel about your weight?
9. Do you consider yourself overweight? ______ Yes ______ No
10. Do you consider yourself underweight? ______ Yes ______ No
11. If you could change one thing about your body what would it be?
12. What do you thing makes a woman look beautiful (on the outside)?
13. If you could change one thing about your inside, what would you
14. Have you every dyed your hair? ______ Yes ______ No
15. If you have dyed your hair, why?
16. Does your mood reflect how you think you look that day?
17. Do you often take time to plan what you will wear and coordinate
your wardrobe before getting dressed?
18. Do you make negative comments about your body or the way you look?
19. Is it difficult for you to accept compliments about your body or the
way you look?
20. Can you think of occasions where you felt really good about how you
looked? Where you felt not so good? When? Why?
21. Are you self-conscious about some parts of your body? Which
22. Do you worry about your weight? ______ Yes ______ No
23. If I asked you to describe yourself, do the positives outnumber the
______ Yes ______ No
24. A friend says look great on a morning when you feel like yesterday¹s
mashed potatoes. You:
______ a. Figure she¹s just being nice.
______ b. Wonder what she wants.
______ c. Tell her, ³Thanks, I needed that.²
______ d. Quickly touch on more makeup before she takes a closer look.
25. After a promising job interview, you don¹t, alas, get an offer.
What to do?
______ a. Tell yourself it¹s too bad you weren¹t what they wanted.
______ b. Try to figure out where the interview went wrong.
______ c. Consult a career counselormaybe you act needs polishing.
______ d. Wonder why you even bothered meeting with people so clearly
lacking in judgment.
26. The men/boys you love/like tend to be:
______ a. Difficult.
______ b. Attractive, but unavailable.
______ c. Desirable in every sense of the word.
______ d. Nice enough men/boys who¹s main asset is their devotion to
27. Additional comments:
Thanks again for your time and trouble.