Exit this survey Students Grades 3-8, Survey on Bullying 1. Post-Survey 2010 Directions: Think about each question carefully. Select the answer that best describes YOU. This survey is anonymous. Question Title * 1. This is how I feel about being at my school: Very happy and good Sometimes happy and good So-so Sometimes sad and unhappy Very sad and unhappy Question Title * 2. This is how safe I feel in each of these places: Very Safe Safe So-So Unsafe Very Unsafe a. in my classroom a. in my classroom Very Safe a. in my classroom Safe a. in my classroom So-So a. in my classroom Unsafe a. in my classroom Very Unsafe b. on the playground b. on the playground Very Safe b. on the playground Safe b. on the playground So-So b. on the playground Unsafe b. on the playground Very Unsafe c. in the lunch room c. in the lunch room Very Safe c. in the lunch room Safe c. in the lunch room So-So c. in the lunch room Unsafe c. in the lunch room Very Unsafe d. walking to/from school d. walking to/from school Very Safe d. walking to/from school Safe d. walking to/from school So-So d. walking to/from school Unsafe d. walking to/from school Very Unsafe e. in the bathroom e. in the bathroom Very Safe e. in the bathroom Safe e. in the bathroom So-So e. in the bathroom Unsafe e. in the bathroom Very Unsafe f. in the hall f. in the hall Very Safe f. in the hall Safe f. in the hall So-So f. in the hall Unsafe f. in the hall Very Unsafe g. at extended day g. at extended day Very Safe g. at extended day Safe g. at extended day So-So g. at extended day Unsafe g. at extended day Very Unsafe Question Title * 3. How often have these things happened to you at school? Everyday 1 or 2 times a week 1 or 2 times a month 1 or 2 times a year Never a. teased in a mean way a. teased in a mean way Everyday a. teased in a mean way 1 or 2 times a week a. teased in a mean way 1 or 2 times a month a. teased in a mean way 1 or 2 times a year a. teased in a mean way Never b. called hurtful names b. called hurtful names Everyday b. called hurtful names 1 or 2 times a week b. called hurtful names 1 or 2 times a month b. called hurtful names 1 or 2 times a year b. called hurtful names Never c. left out of things on purpose c. left out of things on purpose Everyday c. left out of things on purpose 1 or 2 times a week c. left out of things on purpose 1 or 2 times a month c. left out of things on purpose 1 or 2 times a year c. left out of things on purpose Never d. threatened d. threatened Everyday d. threatened 1 or 2 times a week d. threatened 1 or 2 times a month d. threatened 1 or 2 times a year d. threatened Never e. hit, kicked, or pushed e. hit, kicked, or pushed Everyday e. hit, kicked, or pushed 1 or 2 times a week e. hit, kicked, or pushed 1 or 2 times a month e. hit, kicked, or pushed 1 or 2 times a year e. hit, kicked, or pushed Never For Questions 4-8, mark all that apply. Question Title * 4. At school, who has: A group of girls A group of boys A boy A girl Nobody a. bullied you a. bullied you A group of girls a. bullied you A group of boys a. bullied you A boy a. bullied you A girl a. bullied you Nobody b. said mean things to you b. said mean things to you A group of girls b. said mean things to you A group of boys b. said mean things to you A boy b. said mean things to you A girl b. said mean things to you Nobody c. teased you c. teased you A group of girls c. teased you A group of boys c. teased you A boy c. teased you A girl c. teased you Nobody d. called you names d. called you names A group of girls d. called you names A group of boys d. called you names A boy d. called you names A girl d. called you names Nobody e. tried to hurt you at school e. tried to hurt you at school A group of girls e. tried to hurt you at school A group of boys e. tried to hurt you at school A boy e. tried to hurt you at school A girl e. tried to hurt you at school Nobody Question Title * 5. In what grade is the student (or students) who bullies you? In my classroom In the same grade, but different class In a lower grade In a higher grade I haven’t been bullied Question Title * 6. 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 Don’t get bullied Question Title * 7. If you have been bullied, whom have you told? My mother or father My sister or brother A teacher or other adult at school Another student at school Nobody Ive never been bullied Question Title * 8. If you have been bullied, who has tried to help you? My mother or father My sister or brother A teacher or another adult at school Another student at school Nobody I’ve never been bullied Question Title * 9. If you have been bullied, what happened after you told someone? It got better It got worse Nothing changed I never told anyone I’ve never been bullied Question Title * 10. How often do you hit, kick, or push other children? Every day 1 or 2 times a week 1 or 2 times a month 1 or 2 times a year Never Question Title * 11. How often do you: Every Day 1 or 2 Times a Week 1 or 2 Times a Month 1 or 2 Times a Year Never a. say mean things a. say mean things Every Day a. say mean things 1 or 2 Times a Week a. say mean things 1 or 2 Times a Month a. say mean things 1 or 2 Times a Year a. say mean things Never b. tease others b. tease others Every Day b. tease others 1 or 2 Times a Week b. tease others 1 or 2 Times a Month b. tease others 1 or 2 Times a Year b. tease others Never c. call other children names c. call other children names Every Day c. call other children names 1 or 2 Times a Week c. call other children names 1 or 2 Times a Month c. call other children names 1 or 2 Times a Year c. call other children names Never Question Title * 12. How often have you seen someone: Every Day 1 or 2 Times a Week 1 or 2 Times a Month 1 or 2 Times a Year Never a. being teased in a mean way a. being teased in a mean way Every Day a. being teased in a mean way 1 or 2 Times a Week a. being teased in a mean way 1 or 2 Times a Month a. being teased in a mean way 1 or 2 Times a Year a. being teased in a mean way Never b. being threatened b. being threatened Every Day b. being threatened 1 or 2 Times a Week b. being threatened 1 or 2 Times a Month b. being threatened 1 or 2 Times a Year b. being threatened Never c. left out of things on purpose c. left out of things on purpose Every Day c. left out of things on purpose 1 or 2 Times a Week c. left out of things on purpose 1 or 2 Times a Month c. left out of things on purpose 1 or 2 Times a Year c. left out of things on purpose Never d. being called hurtful names d. being called hurtful names Every Day d. being called hurtful names 1 or 2 Times a Week d. being called hurtful names 1 or 2 Times a Month d. being called hurtful names 1 or 2 Times a Year d. being called hurtful names Never e. being hit, kicked, or pushed e. being hit, kicked, or pushed Every Day e. being hit, kicked, or pushed 1 or 2 Times a Week e. being hit, kicked, or pushed 1 or 2 Times a Month e. being hit, kicked, or pushed 1 or 2 Times a Year e. being hit, kicked, or pushed Never Question Title * 13. How often have you noticed bullying going on in these places? Every Day 1 or 2 Times a Week 1 or 2 Times a Month 1 or 2 Times a Year Never a. in my classroom a. in my classroom Every Day a. in my classroom 1 or 2 Times a Week a. in my classroom 1 or 2 Times a Month a. in my classroom 1 or 2 Times a Year a. in my classroom Never b. on the playground b. on the playground Every Day b. on the playground 1 or 2 Times a Week b. on the playground 1 or 2 Times a Month b. on the playground 1 or 2 Times a Year b. on the playground Never c. in the lunchroom c. in the lunchroom Every Day c. in the lunchroom 1 or 2 Times a Week c. in the lunchroom 1 or 2 Times a Month c. in the lunchroom 1 or 2 Times a Year c. in the lunchroom Never d. walking to or from school d. walking to or from school Every Day d. walking to or from school 1 or 2 Times a Week d. walking to or from school 1 or 2 Times a Month d. walking to or from school 1 or 2 Times a Year d. walking to or from school Never e. in the bathroom e. in the bathroom Every Day e. in the bathroom 1 or 2 Times a Week e. in the bathroom 1 or 2 Times a Month e. in the bathroom 1 or 2 Times a Year e. in the bathroom Never f. in the hall f. in the hall Every Day f. in the hall 1 or 2 Times a Week f. in the hall 1 or 2 Times a Month f. in the hall 1 or 2 Times a Year f. in the hall Never g. at extended day g. at extended day Every Day g. at extended day 1 or 2 Times a Week g. at extended day 1 or 2 Times a Month g. at extended day 1 or 2 Times a Year g. at extended day Never h. at car line h. at car line Every Day h. at car line 1 or 2 Times a Week h. at car line 1 or 2 Times a Month h. at car line 1 or 2 Times a Year h. at car line Never Mark all that apply in 14-15. Question Title * 14. Who have you seen doing the bullying? Both boys and girls A group of boys A boy A group of girls A girl Nobody Question Title * 15. What grades are the bullies in? In my classroom In the same grade but in a different class In a lower grade In a higher grade I haven’t seen any bullying Question Title * 16. What is your ethnic group? (optional) Asian Black Hispanic Native American White Question Title * 17. Are you a boy or a girl? Boy Girl Thank you for your answers! Adapted from the Maine Project Against Bullying, http://lincoln.midcoast.com/~wps/against/bullying.html Done