Exit All Is Well Family Extended Mentor Program Question Title * 1. Since you have started school, how many times have you been bullied? Never Sometimes (1 or 2 times a month) Regularly (1 or 2 times a week) Everyday Other (please specify) Question Title * 2. If you have been bullied, will you tell us how you were bullied? I haven't been bullied I have been called names I have been physically assaulted I don’t get to sit at any of the tables during lunch hour Others snatch my lunch and other belongings No one talks to me in school I have been sent threat warnings (Cyberbullied) Other (please specify) Question Title * 3. How many kids have bullied you? NONE 1-2 2-3 3-4 More than 4 Question Title * 4. Where do you think bullying occurs the most? Never During School hours Hallway Classroom Restroom P.E Café Going Home After school Before School Other (please specify) Question Title * 5. In this academic year, how many times have you missed class or school because you felt unsafe to show up to school, or School actives? Never 1 or 2 times a week 1 or 2 times a month 1 or 2 times in 3 months 1 or 2 times in 6 months Everyday Other (please specify) Question Title * 6. If you saw someone being bullied at school would you- Do nothing Take matters in your own hand Report to school authorities Tell your parents Call the police Tell a Friend Participate In Bullying Other (please specify) Question Title * 7. How many times have you bullied others? Never 1 or 2 times a week 1 or 2 times a month Everyday Question Title * 8. Why do you think bullies bully? I am not sure They are big and strong They think it’s fun They want to get even for being bullied They are “show-offs” Their friends dare them to bully others Other (please specify) Question Title * 9. This anti-bullying survey is advantageous to identifying, checking, and stopping bullying on campus . At risk students are prone to increased stress levels, lower academic achievements, leads to dropouts, and self harm. Faculty members plays a significant role in checking and mitigating bullying at the initial stage. Let’s look at the survey benefits: Prevents bullying Supports stressed students Promotes education Tackles harassment Demoralizes bullying Saves lives Assures campus safety Builds parent confidence Optim Question Title * 10. THANKS FOR COMPLETING THIS SURVEY! YOU ARE HELPING THOSE WHO WILL NOT SPEAK UP FOR THEMSELVES. Please let us know "What School do you Attend"! Done