Wheatland Bullying Survey 1. Question Title * 1. I was called mean names, was made fun of, or teased in a hurtful way. 1. Has not happened 2. Once or twice 3. 2-3 times 4. Once a week 5. Several times a week Question Title * 2. I was hit, kicked, or shoved. 1. Has not happened 2. Once or twice 3. 2-3 times 4. Once a week 5. Several times a week Question Title * 3. Other students kept me out of things on purpose, excluded me from their group of friends or completely ignored me. 1. Has not happened 2. Once or twice 3. 2-3 times 4. Once a week 5. Several times per week Question Title * 4. Other students told lies or false rumors about me and tried to make others dislike me. 1. Has not happened 2. Once or twice 3. Two or three times 4. Once a week 5. Several times per week Question Title * 5. I was bullied with mean names or comments about my race or color. 1. Has not happened 2. Once or twice 3. Two or three times 4. Once a week 5. Several times per week Question Title * 6. I was bullied with mean names, comments or gestures with a sexual meaning. 1. Has not happened 2. Once or twice 3. Two or three times 4. Once a week 5. Several times per week Question Title * 7. Have you been bullied by boys or girls? 1. Mainly by 1 girl 2. By several girls 3. Mainly by 1 boy 4. By several boys 5. Both boys and girls Question Title * 8. If you have been bullied at school, where were you bullied? 1. On the playground at recess 2. In the hallways 3. In the classroom with the teacher present 4. In the bathrooms 5. In the cafeteria Question Title * 9. If you were bullied off school grounds, where did this happen? 1. On the way to and from school 2. At the bus stop 3. On the school bus 4. Somewhere else in school 5. At the car rider pick up Question Title * 10. If you were bullied at school during the past two months, have you told anyone that you have been bullied?? 1. Been bullied but not told anyone 2. Been bullied and reported it to someone Question Title * 11. How often have you taken part in bullying another student at school in the past two months? 1. Has not happened 2. Once or twice 3. Two to three times 4. Once a week 5. Several times a week Question Title * 12. I called another student(s) mean names, made fun of or teased him or her in a hurtful way. 1. Has not happened 2. Once or twice 3. Two to three times 4. Once a week 5. Several times per week Question Title * 13. If you have bullied another student in the past two months read and select the answer that best describes the statement.I kept the other student out of things on purpose, excluded him or her from my group of friends or completely ignored him or her. 1. Has not happened 2. Once or twice 3. Two to three times 4. Once per week 5. Several times per week Question Title * 14. If you have bullied another student select the best description to the statement.I spread false rumors about him or her and tried to make others dislike him or her. 1. Has not happened 2. Once or twice 3. Two or three times 4. Once a week 5. Several times per week Question Title * 15. Has your teacher or any other teacher or adult talked with you about your bullying other students at school in the past two months? 1. No, no one has talked to me about bullying 2. Yes, they have once 3. Yes, they have several times Question Title * 16. Do you think you could join in bullying a student whom you did not like? 1. Yes 2. Yes, maybe 3. No, I don't think so 4. No 5. Definitely no Question Title * 17. How do you react if you see or understand that a student your age is being bullied by other students? 1. I have never noticed it 2. I take part in the bullying 3. I don't do the bullying but I find it ok 4. I just watch what is happening 5. I try to help Question Title * 18. How often are you afraid of being bullied by other students in your school? 1. Never 2. Seldom 3. Sometimes 4. Fairly often 5. Often Done