Intermediate Bullying Survey

1. Intermediate Bullying Survey

Please complete this short survey to provide feedback for the Auburn Washburn School District about bullying behavior in the intermediate school. For the purpose of this survey the items listed in question (II) identify the various kinds of behaviors that are considered bullying behaviors.

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* 1. I am

Male

Female

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* 2. I am in the

3rd Grade

4th Grade

5th Grade

6th Grade

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* 3. If you have been bullied, who did the bullying?

boys

girls

both boys and girls

I haven’t been bullied

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* 4. In what grade is the student (or students) who have bullied you?

in my grade

in a lower grade

in a higher grade

I haven’t been bullied

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* 5. What grade or grades were you in when you were bullied? (Mark all that apply)

Kindergarten

1st

2nd

3rd

4th

5th

6th

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* 6. This is how safe I feel from being bullied in each of these places.

	Very Safe	Kind of Safe	Kind of Unsafe	Very Unsafe	Not Applicable
in my classroom	in my classroom Very Safe	in my classroom Kind of Safe	in my classroom Kind of Unsafe	in my classroom Very Unsafe	in my classroom Not Applicable
on the playground	on the playground Very Safe	on the playground Kind of Safe	on the playground Kind of Unsafe	on the playground Very Unsafe	on the playground Not Applicable
in the lunch room	in the lunch room Very Safe	in the lunch room Kind of Safe	in the lunch room Kind of Unsafe	in the lunch room Very Unsafe	in the lunch room Not Applicable
walking to or from school	walking to or from school Very Safe	walking to or from school Kind of Safe	walking to or from school Kind of Unsafe	walking to or from school Very Unsafe	walking to or from school Not Applicable
in the bathroom	in the bathroom Very Safe	in the bathroom Kind of Safe	in the bathroom Kind of Unsafe	in the bathroom Very Unsafe	in the bathroom Not Applicable
in the hall	in the hall Very Safe	in the hall Kind of Safe	in the hall Kind of Unsafe	in the hall Very Unsafe	in the hall Not Applicable
on the bus	on the bus Very Safe	on the bus Kind of Safe	on the bus Kind of Unsafe	on the bus Very Unsafe	on the bus Not Applicable
at the bus stop	at the bus stop Very Safe	at the bus stop Kind of Safe	at the bus stop Kind of Unsafe	at the bus stop Very Unsafe	at the bus stop Not Applicable

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* 7. How often have these things happened to you at school? (Choose the answer that is closest to the number of times it has happened to you.)

	Everyday	1 or 2 times a week	1 or 2 times a month	1 or 2 times a year	Never
been teased in a mean way	been teased in a mean way Everyday	been teased in a mean way 1 or 2 times a week	been teased in a mean way 1 or 2 times a month	been teased in a mean way 1 or 2 times a year	been teased in a mean way Never
called hurtful names	called hurtful names Everyday	called hurtful names 1 or 2 times a week	called hurtful names 1 or 2 times a month	called hurtful names 1 or 2 times a year	called hurtful names Never
left out of things on purpose	left out of things on purpose Everyday	left out of things on purpose 1 or 2 times a week	left out of things on purpose 1 or 2 times a month	left out of things on purpose 1 or 2 times a year	left out of things on purpose Never
been threatened	been threatened Everyday	been threatened 1 or 2 times a week	been threatened 1 or 2 times a month	been threatened 1 or 2 times a year	been threatened Never
been hit or kicked or pushed	been hit or kicked or pushed Everyday	been hit or kicked or pushed 1 or 2 times a week	been hit or kicked or pushed 1 or 2 times a month	been hit or kicked or pushed 1 or 2 times a year	been hit or kicked or pushed Never

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* 8. At school who has done these things to you?

	Both Boys and Girls	A Boy or a Girl	A Group of Boys	A Group of Girls	Nobody
been teased in a mean way	been teased in a mean way Both Boys and Girls	been teased in a mean way A Boy or a Girl	been teased in a mean way A Group of Boys	been teased in a mean way A Group of Girls	been teased in a mean way Nobody
called hurtful names	called hurtful names Both Boys and Girls	called hurtful names A Boy or a Girl	called hurtful names A Group of Boys	called hurtful names A Group of Girls	called hurtful names Nobody
left out of things on purpose	left out of things on purpose Both Boys and Girls	left out of things on purpose A Boy or a Girl	left out of things on purpose A Group of Boys	left out of things on purpose A Group of Girls	left out of things on purpose Nobody
been threatened	been threatened Both Boys and Girls	been threatened A Boy or a Girl	been threatened A Group of Boys	been threatened A Group of Girls	been threatened Nobody
been hit or kicked or pushed	been hit or kicked or pushed Both Boys and Girls	been hit or kicked or pushed A Boy or a Girl	been hit or kicked or pushed A Group of Boys	been hit or kicked or pushed A Group of Girls	been hit or kicked or pushed Nobody

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* 9. If you or a friend were being bullied in school now, whom would you report it to?

	Yes	No
my mother or father	my mother or father Yes	my mother or father No
my sister or brother	my sister or brother Yes	my sister or brother No
another student at school	another student at school Yes	another student at school No
a teacher or another adult at school	a teacher or another adult at school Yes	a teacher or another adult at school No
counselor	counselor Yes	counselor No
principal	principal Yes	principal No
nobody, I would handle it myself	nobody, I would handle it myself Yes	nobody, I would handle it myself No

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* 10. If you or a friend has been bullied, what happened after someone was told about it? (Mark Does Not Apply to Me if you or a friend has not been bullied.)

it got better

it got worse

nothing changed

neither of us told anyone

Does Not Apply to Me

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* 11. If you were bullied or saw someone being bullied, how well did people who work at school handle it?

Adults at school did not deal with the bullying at all

Adults at school handled the bullying poorly

Adults at school handled the bullying well.

Does Not Apply to Me

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* 12. Overall, how would you rate the efforts of adults at your school to prevent students bullying each other?

Very Good

Good

Poor

Very Poor

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* 13. Most teasing I see is done in fun, not to hurt people.

Agree very much

Agree

Disagree

Disagree very much

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* 14. Most students who get bullied bring it on themselves.

Agree very much

Agree

Disagree

Disagree very much

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* 15. Do you feel comfortable about reporting bullying in your school?

Yes

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* 16. If you have ever been bullied outside of school, how did it happen? (Mark all that apply)

on the computer

text messaging

phone calls

sister or brother

other