Gardiner Survey of Bullying and Harassment

1. What is your gender?

What is your gender? Male

Female

2. What grade are you in?

What grade are you in? 7th

8th

3. For how long have you attended this school?

For how long have you attended this school? All year

Part of the year

Just started

4. How big of a problem do you feel there is with bullying or harassment at this school?

How big of a problem do you feel there is with bullying or harassment at this school? Not a problem at all

Kind of a problem

Definitely a problem

A huge Problem

5. How often do you personally feel bullied or harassed?

How often do you personally feel bullied or harassed? Never

Not very often but sometimes

Most of the time

Every day

6. How often do you feel you bully or harass others?

How often do you feel you bully or harass others? Never

Occasionally

About once a week

Pretty often

Every day

7. How often have other students done these things to you at school?
A) Every day B) Once or twice per week C) A couple times per month D) Hardly ever E) Never

	Select One
Physical Things: hit, punched, shoved, grabbed or tripped you	How often have other students done these things to you at school? A) Every day B) Once or twice per week C) A couple times per month D) Hardly ever E) Never Physical Things: hit, punched, shoved, grabbed or tripped you Select One
Stared at you or given you a mean look	Stared at you or given you a mean look Select One
Spread rumors or talked behind your back in a mean way	Spread rumors or talked behind your back in a mean way Select One
Called you names or nicknames you didn't like	Called you names or nicknames you didn't like Select One
Slammed your locker shut	Slammed your locker shut Select One
Unwanted flirting or sexual remarks	Unwanted flirting or sexual remarks Select One
Sent you a mean or inappropriate text message	Sent you a mean or inappropriate text message Select One
Harassed you on the internet (myspace, facebook etc.)	Harassed you on the internet (myspace, facebook etc.) Select One

8. Where at school is harassment or bullying most likely to occur?

Where at school is harassment or bullying most likely to occur? In the cafeteria

The halls

In classrooms

On the bus

Other

Other (please specify)

9. What do you usually do when you are bullied or harassed?

What do you usually do when you are bullied or harassed? Tell an adult

Ignore it

Say something back

Have your friends help you

Stay home from school

Other (please specify)

10. If you are bullied or harassed, who is usually doing it?

If you are bullied or harassed, who is usually doing it? Your friends

Students you don't know

Older students

Students you know but are not friends with

Other (please specify)

Gardiner Survey of Bullying and Harassment
Exit this survey

1. Default Section

1. What is your gender?

2. What grade are you in?

3. For how long have you attended this school?

4. How big of a problem do you feel there is with bullying or harassment at this school?

5. How often do you personally feel bullied or harassed?

6. How often do you feel you bully or harass others?

7. How often have other students done these things to you at school?
A) Every day B) Once or twice per week C) A couple times per month D) Hardly ever E) Never

8. Where at school is harassment or bullying most likely to occur?

9. What do you usually do when you are bullied or harassed?

10. If you are bullied or harassed, who is usually doing it?

Gardiner Survey of Bullying and HarassmentExit this survey

1. Default Section

1. What is your gender?

2. What grade are you in?

3. For how long have you attended this school?

4. How big of a problem do you feel there is with bullying or harassment at this school?

5. How often do you personally feel bullied or harassed?

6. How often do you feel you bully or harass others?

7. How often have other students done these things to you at school?A) Every day B) Once or twice per week C) A couple times per month D) Hardly ever E) Never

8. Where at school is harassment or bullying most likely to occur?

9. What do you usually do when you are bullied or harassed?

10. If you are bullied or harassed, who is usually doing it?

Gardiner Survey of Bullying and Harassment
Exit this survey

7. How often have other students done these things to you at school?
A) Every day B) Once or twice per week C) A couple times per month D) Hardly ever E) Never