Indiana Youth Survey: Survey Participation Application

2026 Indiana Youth Survey Registration

Please read all instructions carefully and complete all fields.

The survey will be administered online only.
Paper surveys will not be available.

For Questions/Concerns: Email us at inys@iu.edu or call 812-855-1237 (INYS Survey Coordinator).

Step 1. Provide contact info for your local survey coordinator

First Name

Last Name

Title

Phone Number
ext.
Email

Street Address

City, State, Zip

County

Step 2. Set Survey Administration Details

When is your spring break? (Enter dates as MM-DD-YYYY)
to

When will you administer the survey?
Surveys must be administered between Jan 26 and Apr 17, 2026.
We recommend you do NOT schedule the survey during the two weeks following Spring Break.
to

Parental Consent - Please carefully review this document in regard to the requirement for parental consent: View Parental Consent Document

(Optional) You have the option to include or exclude mental health questions in your school's survey. (View Mental Health Module)

(Optional) You have the option to include or exclude bullying questions in your school's survey. (View Bullying Module)

(Optional) You have the option to include or exclude social media use questions in your school's survey. (View Social Media Use Module)

Select your school corporation (You may type in the box to filter the results.)
If your corporation is not listed, select 'Other'.

If Other, specify name

Step 3. Register each school

IMPORTANT: You MUST click SKIP next to any school that you are not personally registering at this exact moment in time. If someone else in your school corporation will be registering a school (or has already done so), you should SKIP registering that school. Skipping does not delete an existing registration.
If your school is not shown the list below, click 'Add School' and type in the name.

School Name	Skip
{{school.name}}

Choose Incentive

One or more schools within your school corporation have been randomly selected to receive incentives for participating in the survey. Each selected school is eligible for a $500 incentive and a school-level report.

To ensure the confidentiality of students, a minimum of 30 participants is necessary to receive the school-level report.

For each school, please provide the following information to facilitate payment processing:

The school's EIN
Contact information for the person who handles checks and financial matters for the school

School Name	EIN, Contact Name, Mailing Address, Email, Phone
{{school.name}}

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