Student Bullying Survey

Westbrook School Department began an in depth assessment of the existing culture and climate of the schools in an attempt to address the issue of bullying. The bullying policy was adopted from the Maine School Management Association Sample Policy, Maine Department of Education, Bullying Prevention Maine's Best Practices in Bullying and Harassment Prevention, A Guide for Schools and Communities. This policy was discussed at the policy and planning subcommittee with representations from parents, students, community, faculty, and staff. Westbrook School Committee continued an open and public discussion about the policy and voted to accept the final language as recommended with some revisions. Please complete this survey to help us address the bullying and help us in developing effective strategies.

1. What grade are you in?

What grade are you in? 3

2. What gender are you?

What gender are you? Female

Male

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

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

4. 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 lunch room	In the lunch room Never	In the lunch room Once or twice	In the lunch room A few times a week	In the lunch room 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

5. How often have these things happened to you at school during the last month?

	Never	Once or twice	A few times a week	Almost everyday
Teased in a mean way	*How often have these things happened to you at school during the last month? Teased in a mean way Never	Teased in a mean way Once or twice	Teased in a mean way A few times a week	Teased in a mean way Almost everyday
Called hurtful names	Called hurtful names Never	Called hurtful names Once or twice	Called hurtful names A few times a week	Called hurtful names Almost everyday
Left out of things on purpose	Left out of things on purpose Never	Left out of things on purpose Once or twice	Left out of things on purpose A few times a week	Left out of things on purpose Almost everyday
Threatened	Threatened Never	Threatened Once or twice	Threatened A few times a week	Threatened Almost everyday
Hit or kicked or pushed	Hit or kicked or pushed Never	Hit or kicked or pushed Once or twice	Hit or kicked or pushed A few times a week	Hit or kicked or pushed Almost everyday

6. During the last month at school how often did you see someone:

	Never	Once or twice	A few times a week	Almost everyday
Being teased in a mean way	*During the last month at school how often did you see someone: Being teased in a mean way Never	Being teased in a mean way Once or twice	Being teased in a mean way A few times a week	Being teased in a mean way Almost everyday
Called hurtful names	Called hurtful names Never	Called hurtful names Once or twice	Called hurtful names A few times a week	Called hurtful names Almost everyday
Left out of things on purpose	Left out of things on purpose Never	Left out of things on purpose Once or twice	Left out of things on purpose A few times a week	Left out of things on purpose Almost everyday
Threatened	Threatened Never	Threatened Once or twice	Threatened A few times a week	Threatened Almost everyday
Hit or kicked or pushed	Hit or kicked or pushed Never	Hit or kicked or pushed Once or twice	Hit or kicked or pushed A few times a week	Hit or kicked or pushed Almost everyday

7. During the last month at school how often did you:

	Never	Once or twice	A few times a week	Almost everyday
Tease someone in a mean way	*During the last month at school how often did you: Tease someone in a mean way Never	Tease someone in a mean way Once or twice	Tease someone in a mean way A few times a week	Tease someone in a mean way Almost everyday
Call someone hurtful names	Call someone hurtful names Never	Call someone hurtful names Once or twice	Call someone hurtful names A few times a week	Call someone hurtful names Almost everyday
Leave someone out of things on purpose	Leave someone out of things on purpose Never	Leave someone out of things on purpose Once or twice	Leave someone out of things on purpose A few times a week	Leave someone out of things on purpose Almost everyday
Threaten someone	Threaten someone Never	Threaten someone Once or twice	Threaten someone A few times a week	Threaten someone Almost everyday
Hit or kick or push someone	Hit or kick or push someone Never	Hit or kick or push someone Once or twice	Hit or kick or push someone A few times a week	Hit or kick or push someone Almost everyday

8. During the last month at school who has:

	Both boys and girls	A group of boys	A boy	A group of girls	A girl	Nobody has bullied me
Teased you in a mean way	*During the last month at school who has: Teased you in a mean way Both boys and girls	Teased you in a mean way A group of boys	Teased you in a mean way A boy	Teased you in a mean way A group of girls	Teased you in a mean way A girl	Teased you in a mean way Nobody has bullied me
Called you hurtful names	Called you hurtful names Both boys and girls	Called you hurtful names A group of boys	Called you hurtful names A boy	Called you hurtful names A group of girls	Called you hurtful names A girl	Called you hurtful names Nobody has bullied me
Left you out of things on purpose	Left you out of things on purpose Both boys and girls	Left you out of things on purpose A group of boys	Left you out of things on purpose A boy	Left you out of things on purpose A group of girls	Left you out of things on purpose A girl	Left you out of things on purpose Nobody has bullied me
Threatened you	Threatened you Both boys and girls	Threatened you A group of boys	Threatened you A boy	Threatened you A group of girls	Threatened you A girl	Threatened you Nobody has bullied me
Hit or kicked or pushed you	Hit or kicked or pushed you Both boys and girls	Hit or kicked or pushed you A group of boys	Hit or kicked or pushed you A boy	Hit or kicked or pushed you A group of girls	Hit or kicked or pushed you A girl	Hit or kicked or pushed you Nobody has bullied me

9. During the last month of school, in what grade was the student (or students) who:

	In my classroom	In the same grade, but in a different class	In a lower grade	In a higher grade	Nobody has bullied me
Teased you in a mean way	*During the last month of school, in what grade was the student (or students) who: Teased you in a mean way In my classroom	Teased you in a mean way In the same grade, but in a different class	Teased you in a mean way In a lower grade	Teased you in a mean way In a higher grade	Teased you in a mean way Nobody has bullied me
Called you hurtful names	Called you hurtful names In my classroom	Called you hurtful names In the same grade, but in a different class	Called you hurtful names In a lower grade	Called you hurtful names In a higher grade	Called you hurtful names Nobody has bullied me
Left you out of things on purpose	Left you out of things on purpose In my classroom	Left you out of things on purpose In the same grade, but in a different class	Left you out of things on purpose In a lower grade	Left you out of things on purpose In a higher grade	Left you out of things on purpose Nobody has bullied me
Threatened you	Threatened you In my classroom	Threatened you In the same grade, but in a different class	Threatened you In a lower grade	Threatened you In a higher grade	Threatened you Nobody has bullied me
Hit or kicked or pushed you	Hit or kicked or pushed you In my classroom	Hit or kicked or pushed you In the same grade, but in a different class	Hit or kicked or pushed you In a lower grade	Hit or kicked or pushed you In a higher grade	Hit or kicked or pushed you Nobody has bullied me

10. During the last month at school who have you seen:

	Both boys and girls	A group of boys	A boy	A group of girls	A girl	Nobody has bullied me
Tease someone in a mean way	*During the last month at school who have you seen: Tease someone in a mean way Both boys and girls	Tease someone in a mean way A group of boys	Tease someone in a mean way A boy	Tease someone in a mean way A group of girls	Tease someone in a mean way A girl	Tease someone in a mean way Nobody has bullied me
Call someone hurtful names	Call someone hurtful names Both boys and girls	Call someone hurtful names A group of boys	Call someone hurtful names A boy	Call someone hurtful names A group of girls	Call someone hurtful names A girl	Call someone hurtful names Nobody has bullied me
Leave someone out on purpose	Leave someone out on purpose Both boys and girls	Leave someone out on purpose A group of boys	Leave someone out on purpose A boy	Leave someone out on purpose A group of girls	Leave someone out on purpose A girl	Leave someone out on purpose Nobody has bullied me
Threaten someone	Threaten someone Both boys and girls	Threaten someone A group of boys	Threaten someone A boy	Threaten someone A group of girls	Threaten someone A girl	Threaten someone Nobody has bullied me
Hit or kick or push someone	Hit or kick or push someone Both boys and girls	Hit or kick or push someone A group of boys	Hit or kick or push someone A boy	Hit or kick or push someone A group of girls	Hit or kick or push someone A girl	Hit or kick or push someone Nobody has bullied me

11. During the last month of school, in what grade was the student (or students) who you saw:

	In my classroom	In the same grade, but in a different class	In a lower grade	In a higher grade	Nobody has bullied me
Teased you in a mean way	*During the last month of school, in what grade was the student (or students) who you saw: Teased you in a mean way In my classroom	Teased you in a mean way In the same grade, but in a different class	Teased you in a mean way In a lower grade	Teased you in a mean way In a higher grade	Teased you in a mean way Nobody has bullied me
Called you hurtful names	Called you hurtful names In my classroom	Called you hurtful names In the same grade, but in a different class	Called you hurtful names In a lower grade	Called you hurtful names In a higher grade	Called you hurtful names Nobody has bullied me
Left you out of things on purpose	Left you out of things on purpose In my classroom	Left you out of things on purpose In the same grade, but in a different class	Left you out of things on purpose In a lower grade	Left you out of things on purpose In a higher grade	Left you out of things on purpose Nobody has bullied me
Threatened you	Threatened you In my classroom	Threatened you In the same grade, but in a different class	Threatened you In a lower grade	Threatened you In a higher grade	Threatened you Nobody has bullied me
Hit or kicked or pushed you	Hit or kicked or pushed you In my classroom	Hit or kicked or pushed you In the same grade, but in a different class	Hit or kicked or pushed you In a lower grade	Hit or kicked or pushed you In a higher grade	Hit or kicked or pushed you Nobody has bullied me

12. When I am bullied, I:

When I am bullied, I: Do Nothing

Tell the bully to stop

Get away from the bully

Hurt other kids

Stay home from school

Tell an adult

Tell a friend

I don't get bullied

13. If you have been bullied in the last month, who have you told?

If you have been bullied in the last month, who have you told? My mother or father

My sister or brother

A teacher or another adult at school

Another student at school

Nobody

I don't get bullied

14. If you have been bullied in the last month, who tired to help you?

If you have been bullied in the last month, who tired to help you? My mother or father

My sister or brother

A teacher or another adult at school

Another student at school

Nobody

I don't get bullied

15. If you have been bullied in the last month, what happened after you told someone?

If you have been bullied in the last month, what happened after you told someone? It got better

It got worse

Nothing changed

I never told anyone

I don't get bullied

Student Bullying SurveyExit this survey

1. What grade are you in?

2. What gender are you?

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

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

5. How often have these things happened to you at school during the last month?

6. During the last month at school how often did you see someone:

7. During the last month at school how often did you:

8. During the last month at school who has:

9. During the last month of school, in what grade was the student (or students) who:

10. During the last month at school who have you seen:

11. During the last month of school, in what grade was the student (or students) who you saw:

12. When I am bullied, I:

13. If you have been bullied in the last month, who have you told?

14. If you have been bullied in the last month, who tired to help you?

15. If you have been bullied in the last month, what happened after you told someone?

Student Bullying Survey
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