2018 Indiana Youth Survey Registration

Please read all instructions carefully and complete all fields.

For Questions/Concerns: Contact Susan Samuel at inys@indiana.edu.

Step 1. Provide contact info for your local survey coordinator



Step 2. Set Survey Administration Details

(View Sample Survey Form: 6th Grade | 7-12th Grade)

(Click in the boxes to bring up a calendar.)

We recommend you do NOT schedule the survey during the two weeks following Spring Break.

(Click the arrow or type in the box.)
If your corporation is not listed, select 'Other'.

Step 3. Register each school

You may register one or more schools in your corporation for the survey. For each school, record the number of classrooms doing the paper survey and the number of classrooms doing the online survey.

Important: If any of the schools you wish to register have different answers for Step 1 or Step 2, you must register them separately (by completing this page more than once). For example, if two schools have different Local Survey Coordinators or different survey dates, you must register them separately.

Important: Some schools may have automatically been added to the list below when you answered School Corporation.
  • To add a school to the list, click 'Add School' and then type in the name of the school.
  • To remove a school from the list (because it is not participating or because someone else will register it), click 'Remove School' next to that school.
School Name # of Classrooms
- Paper Survey
# of Classrooms
- Online Survey

Step 4. How many paper surveys will you need?

Based on the number of classrooms using the paper survey you recorded above, please calculate the number of students that will need paper surveys. If you are only doing the online survey, enter '0'.

  I acknowledge that the Indiana Prevention Resource Center (IPRC) will combine my school’s data with all other schools to generate state-level reports. No schools will be identified in the reports. Also, the IPRC may share the aggregated data (without any school identifiers) with researchers for further research on substance use among youth. Individual school data will remain confidential unless I provide a written permission letter/email for the data to be released to a third party.