This document contains an example technology use survey with 5 questions about texting habits, social media use, and favorite apps. It then provides a sample survey of responses from 5 students. The questions ask about number of daily texts, feelings about Facebook, main phone uses, favorite current programs/apps, and photo upload locations. The sample surveys 5 students' responses to these questions. It concludes by asking the reader to conduct their own survey of 5 people and write a short report on the results.