Dear Student,

We need your help to find out what you like about your school and what could be made better. Please answer the questions below.

This is not a test. There are no right or wrong answers. We hope that you will feel free to be totally honest and answer the questions in a way that shows how you really feel.

This is a survey that has to deal with bullying and harassment in school. Please read the definition below.

Bullying - is defined as intimidation or harassment of a student or students brought about by individuals or groups. It involves an imbalance of power, having an intent to harm, repeated over time, a possible threat or aggression, and/or creating terror to maintain dominance. Bullying includes but is not limited to: physical actions (violence, gestures, theft, or damaging property); oral or written taunts (name-calling, put downs, threats, or extortion); or threats of retaliation for reporting such acts.

Bullying may also include cyberbullying or cyberthreats. Cyberbullying is sending or posting harmful or cruel text or images using the internet or other digital communication devices. Cyberthreats are online materials that threaten or raise concerns about violence against others, suicide, or self-harm.

Please select the appropriate response.

* 1. I attend school at:

* 2. I am in Grade:

* 3. I am:

* 4. Overall, do you believe this is a safe school?

* 5. Have you been a part of a group who bullied or hurt another student this year at school?

* 6. Have you been in trouble for picking on, bullying, or starting rumors about another student this year at school?

* 7. Have you stolen or destroyed another student's property this year at school? 

* 8. Have you been bullied or harassed by another student this year at school?

* 9. How many times have you missed school this year due to fear of being hurt or bullied by other students?

* 10. Overall, how would you rank the problem of bullying at your school?

* 11. How often do you think students bully or harass other students in your school?

* 12. Do you believe that you are safe from students who bully at school?

* 13. Do you think students who bully are ever admired or liked at school?

* 14. Do you think staff (principals, counselors, teachers, coaches, aides, etc.) are effective at stopping bullying/harassment in school?

* 15. Please mark the places where you have been bullied this year at school.

Please check all that apply:

* 16. Please mark the ways you have been bullied this year at school.

Please check all that apply:

* 17. Do you believe you can count on adults in your school to protect you from being bullied by others?

* 18. How did you learn about the Sikeston Public Schools' bullying policy regarding violence, bullying, and harassment? 

Please check all that apply.

* 19. Whom would you tell if you were being bullied or harassed by another student?

Please check all that apply: