2011-2012 Bully Prevention Survey for Students
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1
. What grade are you in?
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
What grade are you in?
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2
. Are you a male or female?
Are you a male or female?
A. Male
B. Female
3
. When you think about bullying, which of the following behaviors come to mind (choose all answers that apply)?
When you think about bullying, which of the following behaviors come to mind (choose all answers that apply)?
Being left out
Spreading rumors
Threatening
Playing mean tricks
Pushing / shoving
Name calling
Stealing
Being embarrassed by others
Hitting
Inappropriate language
Cyber (Internet and cell phone) bullying
Other (please specify)
4
. Do you learn about bullying at school (for example have you learned about what a bullying is and what to do if there is bullying at our school)?
Do you learn about bullying at school (for example have you learned about what a bullying is and what to do if there is bullying at our school)?
Yes
No
5
. Do you feel safe at school?
Do you feel safe at school?
Never
Sometimes
Often
Always
6
. Where do you see bullying at our school?
Where do you see bullying at our school?
I do not see bullying at our school
In the classroom
In hallways/stairwells
On the way to and from school
Cafeteria
Car circle
Sibling room
Bathrooms
Before and after school programs
Media center
Music
Art
PE
Other (please specify)
7
. If you see someone getting bullied, what do you do?
If you see someone getting bullied, what do you do?
I watch and join in on the bullying.
I walk away and get help.
I ignore it, walk away and don't tell anyone.
I try to stop the bullying or help the victim
I have never seen someone get bullied.
8
. What do adults/teachers do when they see bullying at our school?
What do adults/teachers do when they see bullying at our school?
I have never seen bullying at our school.
They stop it and help solve the problem.
Nothing; they ignore it
I don't know
9
. Define bullying
Define bullying
10
. Has anyone bullied you?
Has anyone bullied you?
Yes
No
If yes, tell how you were bullied, where you were bullied and how long ago. Please contact Mrs. Bauman if this is still an ongoing concern of yours.
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