Intermediate Bullying Survey 2010

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1. I am a

I am a   Girl Boy

2. I am pushed, kicked, or hit at school.

I am pushed, kicked, or hit at school.   Never Sometimes A lot

3. I am pushed, kicked, or hit on the bus.

I am pushed, kicked, or hit on the bus.   Never Sometimes A lot

4. I am called names, put down, teased, or left out of a group at school.

I am called names, put down, teased, or left out of a group at school.   Never Sometimes A lot

5. I am called names, put down, teased, or left out of a group on the bus.

I am called names, put down, teased, or left out of a group on the bus.   Never Sometimes A lot

6. I bully others at school.

I bully others at school.   Never Sometimes A lot

7. I bully others on the bus.

I bully others on the bus.   Never Sometimes A lot

8. I see bullying happening...

	Never	Sometimes	A lot
In restrooms	*I see bullying happening... In restrooms Never	In restrooms Sometimes	In restrooms A lot
In classrooms	In classrooms Never	In classrooms Sometimes	In classrooms A lot
In hallways	In hallways Never	In hallways Sometimes	In hallways A lot
In the cafeteria	In the cafeteria Never	In the cafeteria Sometimes	In the cafeteria A lot
On the playground	On the playground Never	On the playground Sometimes	On the playground A lot
On the bus	On the bus Never	On the bus Sometimes	On the bus A lot

9. I get bullied on my way to and from school while riding my bike or walking.

I get bullied on my way to and from school while riding my bike or walking.   Never Sometimes A lot I don't ride my bike or walk to school.

10. I worry about being bullied when I'm in school.

I worry about being bullied when I'm in school.   Never Sometimes A lot

*

11. If someone bullies me I

If someone bullies me I   First strategy
Second strategy
Third strategy

*

12. If I see someone else being bullied I

If I see someone else being bullied I   First strategy
Second strategy
Third strategy

*

13. To help me feel safe at our school I think adults should

To help me feel safe at our school I think adults should   First idea
Second idea
Third idea

14. When I go to an adult at school about bullying, they help me.

When I go to an adult at school about bullying, they help me.   Never Sometimes A lot

15. When I go to my bus driver about bullying on the bus, they help me.

When I go to my bus driver about bullying on the bus, they help me.   Never Sometimes A lot I don't ride a bus

If bus rider: My bus number is