Informed Consent Form

This is to certify that I hereby agree to participate as volunteer in a scientific investigation as an authorized part of the education and research program of Canterbury Christchurch University under the supervision of Stuart Urquhart. The investigation and my part in the investigation have been defined and fully explained to me by the investigator, and I understand this explanation. A description of any risks and discomforts has been discussed in detail with me and I have been given an opportunity to ask whatever questions I may have. I understand that any data or answers to questions will remain confidential with regard to my identity and I understand that I am free to withdraw from this study at any time. Participant Name: Investigator Name: Stuart Urquhart

Firstly please specify your age and gender. Gender: Male/Female Age: Section 1 This first section will examine your habits and attitudes towards the popular social networking site Facebook. Please answer the questions truthfully and remember that this questionnaire is confidential and the information will be used for the purposes of this research only. Please read the following statements and delete the not applicable.
1.

On average, approximately how many minutes per day do you spend on Facebook? 10 or less 1030 3160 12 h 23 h 3+ h

2.

Facebook is part of my everyday activity Agree Strongly Agree

Strongly Disagree Disagree Neutral

I am proud to tell people Im on Facebook Agree Strongly Agree

Strongly Disagree Disagree Neutral

I dedicate a part of my daily schedule to Facebook Agree Strongly Agree

Strongly Disagree Disagree Neutral

I feel out of touch when I havent logged on to Facebook for awhile Agree Strongly Agree

Strongly Disagree Disagree Neutral

I feel I am part of the Facebook community Agree Strongly Agree

Strongly Disagree Disagree Neutral

I would be sad if Facebook shut down Agree Strongly Agree

Strongly Disagree Disagree Neutral

Approximately how long have you had your Facebook profile?

6 months 1 year 1.5 years 2 years 2.5 years 3+ years

How satisfied are you with Facebook, overall?

Not satisfied Barely satisfied Neutral Satisfied Very satisfied

Section 2 The following sections will examine how you perceive yourself. Please answer the questions truthfully and remember that this questionnaire is confidential and the information will be used for the purposes of this research only. Please read the following statements and put a 1 in the place of the box that best describes you as you are generally.
Very Inac cura te Mod erat ely Inac cura te Neit her Inac cura te nor Accu rate Mod erat ely Accu rate Very Accu rate

I am the life of the party I feel comfortable around people I start conversation I talk to a lot of different people at parties I don't mind being the centre of attention I don't talk a lot I keep in the background I have little to say I don't like to draw attention to myself I am quiet around strangers I am relaxed most of the time I seldom feel blue I get stressed out easily I worry about things I am easily disturbed I get upset easily I change my mood a lot I have frequent mood swings I get irritated easily I often feel blue I have a rich vocabulary I have a vivid imagination I have excellent ideas I am quick to understand things

I use difficult words

I spend time reflecting on things I am full of ideas I have difficulty understanding abstract ideas I am not interested in abstract ideas I do not have a good imagination I am interested in people I sympathise with others' feelings I have a soft heart I take time out for others I feel others' emotions I make people feel at ease I am not really interested in others I insult people I am not interested in other people's problems I feel little concern for others I am always prepared I pay attention to details I get jobs done right away I like order I follow a schedule I am exacting in my work I leave my belongings around I make a mess of things I often forget to put thinks back in their proper place I shirk my duties

Section 3 Please answer the questions truthfully and remember that this questionnaire is confidential and the information will be used for the purposes of this research only. Please read the following statements and choose the statement that describes you best and put an A or B in the space provided.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. A. Modesty doesn't become me. B. I am essentially a modest person. A. I would do almost anything on a dare. B. I tend to be a fairly cautious person. A. I can usually talk my way out of anything. B. I try to accept the consequences of my behaviour. A. I prefer to blend in with the crowd. B. I like to be the centre of attention. A. I find it easy to manipulate people. B. I don't like it when I find myself manipulating people. A. I don't particularly like to show off my body. B. I like to show off my body. A. I can read people like a book. B. People are sometimes hard to understand. A. My body is nothing special. B. I like to look at my body. A. I try not to be a show off. B. I will usually show off if I get the chance. A. Sometimes I tell good stories. B. Everybody likes to hear my stories. A. I don't care about new fads and fashions. B. I like to start new fads and fashions. A. I like to look at myself in the mirror. B. I am not particularly interested in looking at myself in the mirror. A. I really like to be the centre of attention. B. It makes me uncomfortable to be the centre of attention. A. People sometimes believe what I tell them. B. I can make anybody believe anything I want them to.

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15.

A. I get upset when people don't notice how I look when I go out in public. B. I don't mind blending into the crowd when I go out in public.

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Section 4 Please answer the questions truthfully and remember that this questionnaire is confidential and the information will be used for the purposes of this research only. Please read the following statements and check the like me column if it describes how you usually feel and the unlike me column if it does not describe how you usually feel.
Like me Unlike me 1. I spend a lot of time daydreaming. 2. Im pretty sure of myself. 3. I often wish I were someone else. 4. Im easy to like. 5. My family and I have a lot of fun together. 6. I never worry about anything. 7. I find it very hard to talk in front of a group. 8. I wish I were younger. 9. There are lots of things about myself Id change if I could. 10. I can make up my mind without too much trouble. 11. Im a lot of fun to be with. 12. I get upset easily at home. 13. I always do the right thing. 14. Im proud of my work. 15. Someone always has to tell me what to do. 16. It takes me a long time to get used to anything new. 17. Im often sorry for the things I do. 18. Im popular with people my own age. 19. My family usually considers my feelings. 20. Im never happy. 21. Im doing the best work that I can. ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________ ________

22. I give in very easily. 23. I can usually take care of myself. 24. I would rather associate with people younger than me. 25. My family expects too much of me. 26. I like everyone I know. 27. Its pretty tough to be me. 28. Things are all mixed up in my life. 29. No one pays much attention to me at home. 30. I never get scolded. 31. Im not doing as well at work as Id like to. 32. I really dont like being a man/woman. 33. I have a low opinion of myself. 34. I dont like to be with other people. 35. There are many times when Id like to leave home. 36. Im never shy. 37. I often feel upset. 38. I always tell the truth.

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Thank you very much for your time