[] smoked
[] consumed alcohol
[] slept in the same bed with someone of the opposite sex
[X] slept in the same bed with someone of the same sex
[] kissed someone of the same sex
[] had sex
[X] had someone in your room other than family
[] watched porn
[] bought porn
[] tried drugs

SUB-TOTAL: 2

[x] taken painkillers
[] taken someone else's prescription medicine
[X] lied to your parents
[X] lied to a friend
[] snuck out of the house
[] done something illegal
[X] felt hurt
[X] hurt someone
[X] wished someone to die
[] seen someone die

SUB-TOTAL: 6

[] missed curfew
[] stayed out all night
[] eaten a carton of ice cream by yourself
[] been to a therapist
[] received a ticket
[] been to rehab
[] dyed your hair
[] been in an accident
[] been to a club
[] been to a bar

SUB-TOTAL: 0

[] been to a wild party
[] been to a Mardi Gras parade
[] drank more than three alcoholic beverages in a night
[] had a spring break in Florida
[] sniffed anything
[X] wore black nail polish
[x] wore arm bands
[] wore t-shirts with band names
[] listened to rap

SUB-TOTAL: 2

[X] dressed gothic
[] dressed girly
[] dressed punk
[] dressed grunge
[] stole something
[] been too drunk to remember anything
[] blacked out
[] fainted
[] had a crush on a neighbor

SUB-TOTAL: 1

[X] had a crush on a friend
[X] been to a concert
[] dry-humped someone; been dry humped
[] been called a slut
[X] called someone a slut
[] installed speakers in a car
[] broken a mirror
[] showered at someone of the opposites sex's house
[] brushed your teeth with someone else's toothbrush

SUB-TOTAL: 3

[] considered Ludacris your favorite rapper?
[X] seen an R-rated movie
[] cruised the mall
[x] skipped school
[] had surgery
[X] had an injury
[] gone to court
[] walked out of a restaurant without paying/tipping
[] caught something on fire
[] lied about your age

SUB-TOTAL: 3

[] owned/rented an apartment/house
[] broke the law in the police's presence
[] made out with someone who had a GF/BF
[] got in trouble with the police
[X] talked to a stranger
[] hugged a stranger
[] kissed a stranger
[] rode in the car with a stranger
[X] been harassed
[X] been verbally harassed

SUB-TOTAL: 3

[X] met face-to-face with someone you met online
[X] stayed online for 5+ hours straight
[X] talked on the phone for more than 4 hours straight
[x] watched TV for 5 hours straight
[X] been to a fair
[] been called a bad influence
[] drank and drove
[] prank-called someone
[] laid on a couch with someone of the opposite sex
[X] cheated on a test

SUB-TOTAL: 6

Total: 26


If you have 00-10 ... write [I'm a goody-goody]
If you have 11-20 ... write [I'm still a goody-goody]
If you have 21-30 ... write [I'm average]
If you have 31-40 ... write [I'm a bad kid]
If you have 41-50 ... write [I'm a very bad influence]
If you have 51-60 ... write [I'm a horrible person]
If you have 61-70 ... write [I should be in jail]
If you have 71-80 ... write [I should be dead]
If you have 81-90 ... write [I got a ticket to Hell]