To design programs for middle school students, we need to learn more about what you do and what you think about your school. Sometimes students call each other names and behave in other ways that make the school an unsafe environment. By answering the questions in this survey, you can help us understand what is happening at your middle school and help your teachers, parents, and administrators make plans to address these behaviors. Some of the questions may ask things you have never thought about, so just give us your best answer. All of your answers will be completed confidential - no one, neither your parents nor anyone from your school, will ever see how you answer these questions. However, if you indicate anywhere on the survey that you are thinking of harming yourself or if someone else is currently harming you, then we will give your name to your principal. We will be averaging answers from a large number of students so please be sure to tell us exactly what you think about things. Your participation is voluntary, so you do not have to participate if you do not want to. You can stop completing the survey at any time and you can skip any question that you do not want to answer. Some items might make you feel sad or make you think about some things that might have upset you in the past. Therefore, we encourage you to talk to your friends, family, teachers, or other individuals that you trust after this survey. 

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* 1. Student ID (note: please do not use your name or school ID)

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* 2. School Name

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* 3. Age

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* 4. Gender

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* 5. Grade

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* 6. Race

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* 7. Who do you live with (check all that apply)?

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* 8. What is your overall grade average this year?

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* 9. Do you play sports or are in activities?

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* 10. Which sport(s)? Check all that apply.

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* 11. What is your sexual orientation?

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* 12. Do you have a disability?

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* 13. Do you know what your disablility is called?

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* 14. Are you in special classes for your disability?

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* 15. Please choose the answer that best reflects how much you agree or disagree with the following statements

  Strongly Disagree Disagree Agree Strongly Agree
I feel proud of belonging to my middle school
I am treated with as much respect as other students are
The teachers here respect me
There is at least one teacher or other adult in this school I can talk to if I have a problem
I feel very different from most other students here

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* 16. How often would you say the following about yourself?

  Never Seldom Sometimes Often  Always
I can listen to others 
Kids I don't like can have good ideas
I get upset when my friends are sad
I trust people who are not my friends
I am sensitive to other people's feelings, even if they are not my friends

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* 17. Now we would like to learn about the people in your life. How many people in your life fit the following descriptions?

  None Some A Lot
At school there are adults I can talk to, who care about my feelings and what happens to me
There are people in my family I can talk to, who care about my feelings and what happens to me
I have friends I can talk to, who care about my feelings and what happens to me
At school there are adults I can talk to, who give good suggestions and advice about my problems
There are people in my family I can talk to, who give me good suggestions and advice about my problems
I have friends who I can talk to, who give me good suggestions and advice about my problems. 
At school, there are adults who help me with practical problems, like helping me get somewhere or helping with a project
There are people in my family who help me with practical problems, like helping me get somewhere or helping me with a project
I have friends who help me with practical problems, like how to get somewhere or helping me with a project

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* 18. For each of the following questions, choose how many times you did this activity or how many times these things happened to you at school in the LAST 30 DAYS

  Never 1 or 2 times 3 or 4 times 5 or 6 times 7 or more times
I upset other students for the fun of it
In a group I teased other students
I fought other students I could easily beat
Other students picked on me
I got in a physical fight
I spread rumors about other students
I started (instigated) arguments or conflicts
I helped harass other students
I hit back when someone hit me first
Other students called me "gay"
I threatened to hurt or hit another student
I got in a physical fight because I was angry
I lost my temper for no reason
Other students called me names
I encouraged people to fight
I teased other students
I called other students "gay."
I was mean to someone when I was angry
I was angry all day
I got hit and pushed by other students

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* 19. Now, we would like for you to think of your siblings or other children in your family. For each of the following questions, choose how many times you did this activity or how many times these things happened to you in the LAST 30 DAYS among your siblings and/or other children in your home.

  Never 1 or 2 times 3 or 4 times 5 or 6 times 7 or more times
I upset them for the fun of it
Others picked on me
I got in a physical fight
I started (instigated) arguments or conflicts
I hit back when someone hit me first
I teased them

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* 20. For the following questions answer how true the following statements are for you:

  not at all true somewhat true pretty true completely true
To look cool, I tease other students
To look cool, I get in fights with other students
To make me feel good, I tease other students
To make me feel good, I get in fights with other students
To make a good impression on my friends I tease other students
To get respect I tease other students
To get respect I get in fights with other students

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* 21. For each of the following questions, choose how many times you did this activity or how many times these things happened to you in the LAST 30 DAYS

  Never 1 or 2 times 3 or 4 times 5 or 6 times 7 or more times
Said or did nice things for other kids
Tried to cheer up other kids who feel upset or sad
I let others know that I cared about them
I helped out other kids when they needed it

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* 22. How much do you agree or disagree with the following statements about yourself?

  Strongly disagree Disagree Agree Strongly agree
A little teasing doesn't hurt anyone
I don't care what mean things kids say, as long as it's not about me
If other students are being teased too much, it's not my problem. 

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* 23. Choose the answer that best reflects how much you agree or disagree with the following statements

  Strongly Disagree Disagree Agree Strongly Agree
If a kid is being teased a lot, I will tell an adult at my school
If a student is teasing another student a lot, I will tell him or her to stop
When a kid is being teased, I stick up for him or her
If a student is teasing a good friend of mine, I will tell him or her to stop. 
If a good friend is being teased a lot, I will tell an adult in my school 

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* 24. In the last 30 days, how often...

  never not often sometimes often almost always
Were you very sad?
Were you grouchy or irritable or in a bad mood?
Did you worry a lot?
Did you feel hopeless about the future?
Did you feel like not eating or eating more than usual?
Did you feel happy?
Did you feel nervous or afraid that things won't work out the way I would like them to?
Did you sleep a lot more or a lot less than usual?
Did you have difficulty concentrating on your schoolwork?

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* 25. How often do you feel the following...

  never not often sometimes often almost always
I usually feel I'm the kind of person I want to be
I feel I can do things as well as other people can
I feel that I am a special or important person
I feel that I am really good at things I try to do

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* 26. In the last YEAR, how many times have you...

  never 1 or 2 times 3 or 5 times 6 or 9 times 10 or more times
Been in in-school or out-of-school suspension?
Stolen something from another student?
Snuck into someplace without paying such as a movie or onto a bus?
Skipped school?
Cheated on a test?
Taken something from a store without paying for it (shoplifted)?
Written things or sprayed paint on walls or sidewalks or cars where you were not supposed to?
Damaged school or other property that did not belong to you?
Drank beer (more than a sip or taste)?
Drank wine or wine coolers or more (more than a sip or taste)?
Smoked cigarettes?
Been drunk?
Drank liquor (like whisky, vodka, or gin)?
Used marijuana (pot, hash, reefer)?
Used inhalants?
Used other drugs (nonprescription)? 

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* 27. During the last year, how often, if at all, did someone do the following things to you?

  not sure never rarely occasionally often 
Someone made a rude comment to me 
Someone spread rumors about me online, whether they were true or not.
Someone made a threatening or aggressive comment to me online
Someone sent me a text message that said rude or mean things

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* 28. During the last year, how often, if at all, did you do the following things to others?

  not sure never rarely occasionally often
Made rude comments to anyone
Spread rumors about someone online, whether they were true or not
Made aggressive or threatening comments to anyone online
Sent a text message that said rude or mean things

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* 29. How often would you say the following about yourself?

  never seldom sometimes often always
I have a hard time sitting still
I start things but have a hard time finishing them
I do things without thinking
I need to use a lot of self-control to keep out of trouble

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* 30. How often is the following true about your parents?

  never  seldom often always
My parents ask if I've gotten my homework done
Would your parents know if you did not come home on time?
When I am not at home, one of my parents knows where I am and who I am with.
The rules in my family are clear
My family has clear rules about alcohol and drug use
If you drank some beer or wine or liquor (vodka or gin) without your parents' permission, would you be caught by your parents?
If you carried a handgun without your parents' permission, would you be caught by your parents?
If you skipped school would you be caught by your parents?

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* 31. How often do you.....

  never once in a while fairly often most of the time
Feel easily annoyed or irritated?
Have temper outbursts you cannot control?
Have urges to beat, injure, or harm someone?
Have urges to break or smash things?
Get into frequent arguments?
Shout or throw things?

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* 32. For each of the following questions, choose how many times you did this activity or how many times these things happened to you in the LAST 30 DAYS

  never 1 or 2 times 3 or 4 times 5 or 6 times 7 or more times
I was left out on purpose when it was time to play or do an activity
Another kid who was mad at me got back at me by not letting me be in his/her group anymore
Another kid said he/she wouldn't like me unless I did what he/she wanted me to do
Another kid told lies about me to make other kids not like me anymore
 I told lies about a classmate so that the other kids wouldn't like that classmate anymore.
I tried to keep certain people from being in my group when it was time to hang out or do an activity.
When I was mad at someone, I got back at the person by not letting the person be in my group anymore.
I told my friends that I would stop liking them unless they did what I said.
I tried to keep others from liking a classmate by saying mean things about him/her. 

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