The 2012 Utah ShakeOut Survey can be completed online until June 15, 2012.

To download blank versions of the 2012 ShakeOut Survey, select your category from the list below.

NOTE: The Survey has 5 participation types, each with multiple sections. The files linked to below are blank surveys for each type, excepted from the entire survey. Because many questions are skipped based upon participant responses, the question numbers will not match those in the online survey though they are in the same order.

Select the appropriate survey based on how you responded online:

Yourself and your household

An organization (including business, healthcare, community groups, preschools, faithbased, and all others)

An INDIVIDUAL K12 school (public, private, charter, homeschool etc.)

A GROUP of K12 schools (public school district or county office of education, private or charter)

A university, college or community college

Complete Survey (all participation types in one continuous document)