First name

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* 1. First name

Current role (Example: student, mom, teacher, pastor, 6th grader, etc.)

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* 2. Current role (Example: student, mom, teacher, pastor, 6th grader, etc.)

Please share your experience of being bullied.  (Who? What? When? Where? Why?)

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* 3. Please share your experience of being bullied.  (Who? What? When? Where? Why?)

How did you deal with it at that time? (Example: told a teacher/parent, fought back, hid, etc.)

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* 4. How did you deal with it at that time? (Example: told a teacher/parent, fought back, hid, etc.)

Have you overcome it? If so, how? (Give a few steps you took that helped you.)

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* 5. Have you overcome it? If so, how? (Give a few steps you took that helped you.)

How has this experience made you "better?" (Example: stronger, more compassionate, open-minded, etc.)

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* 6. How has this experience made you "better?" (Example: stronger, more compassionate, open-minded, etc.)

If you could say one encouraging thing to someone who is currently being bullied, what would it be?

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* 7. If you could say one encouraging thing to someone who is currently being bullied, what would it be?

Thank you! All done. In case we need to contact you, what's your best email address?

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* 8. Thank you! All done. In case we need to contact you, what's your best email address?

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