Age:____________ Gender:________________ Grade:________ Do you practice an organized religion? YES NO If so, what? _____________ How often do you attend a place of worship? Daily Weekly Monthly A few times a year Rarely/Never Are your religious beliefs the same as those of your family/culture? YES NO Do you believe in a supreme being? YES NO NOT SURE Do you believe in the concept of heaven and hell? YES NO NOT SURE Do you believe in an afterlife? YES NO Would you say the passage of time has made you… More religious Less religious About the same How true do you find this statement? “Religion is a concept used to maintain control” Very true Somewhat true Neither true nor false Somewhat false Very false