1. How concerned are you about bullying at this school ?

2. During the past school year, how many times, if any, has someone used cell phones or the Internet to say or post hurtful things about you?

3. During the past year, how many times, if any, has someone left you out of or wouldn't let you join in activities on purpose?

4. During the past year, how many times, if any, has someone threatened you with harm?

5. During the past year, how many times, if any, has someone pushed you, shoved you, tripped you, or spit on you?

6. During the past year, how many times, if any, has someone spread rumors about you?

7. During the past year, how many times, if any, has someone made fun of you, called you names, or insulted you?

8. In the past year, how often have you reported to an adult seeing someone bullied or harassed by other students?

9. What stops most students from reporting bullies or acts of harassment to adults?

10. How safe do you feel in coming to Woodstown High School next year?

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