Bullying Questionnaire 3rd grade
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1.

1. This is how safe I feel in each of these places:

	Very unsafe	Kind of unsafe	Kind of safe	Very safe
In the hall	*This is how safe I feel in each of these places: In the hall Very unsafe	In the hall Kind of unsafe	In the hall Kind of safe	In the hall Very safe
In the bathroom	In the bathroom Very unsafe	In the bathroom Kind of unsafe	In the bathroom Kind of safe	In the bathroom Very safe
In my classroom	In my classroom Very unsafe	In my classroom Kind of unsafe	In my classroom Kind of safe	In my classroom Very safe
At the bus stop	At the bus stop Very unsafe	At the bus stop Kind of unsafe	At the bus stop Kind of safe	At the bus stop Very safe
In the lunch room	In the lunch room Very unsafe	In the lunch room Kind of unsafe	In the lunch room Kind of safe	In the lunch room Very safe
On the bus	On the bus Very unsafe	On the bus Kind of unsafe	On the bus Kind of safe	On the bus Very safe
Walking to or from school	Walking to or from school Very unsafe	Walking to or from school Kind of unsafe	Walking to or from school Kind of safe	Walking to or from school Very safe
On the playground	On the playground Very unsafe	On the playground Kind of unsafe	On the playground Kind of safe	On the playground Very safe

2. How often have you noticed bullying going on in these places in the last month?

	Never	Once or twice	A few times a week	Almost everyday
In my classroom	*How often have you noticed bullying going on in these places in the last month? In my classroom Never	In my classroom Once or twice	In my classroom A few times a week	In my classroom Almost everyday
On the playground	On the playground Never	On the playground Once or twice	On the playground A few times a week	On the playground Almost everyday
In the lunchroom	In the lunchroom Never	In the lunchroom Once or twice	In the lunchroom A few times a week	In the lunchroom Almost everyday
Walking to or from school	Walking to or from school Never	Walking to or from school Once or twice	Walking to or from school A few times a week	Walking to or from school Almost everyday
In the bathroom	In the bathroom Never	In the bathroom Once or twice	In the bathroom A few times a week	In the bathroom Almost everyday
In the hall	In the hall Never	In the hall Once or twice	In the hall A few times a week	In the hall Almost everyday
On the bus	On the bus Never	On the bus Once or twice	On the bus A few times a week	On the bus Almost everyday
At the bus stop	At the bus stop Never	At the bus stop Once or twice	At the bus stop A few times a week	At the bus stop Almost everyday

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