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Bullying Survey

Bullying Survey

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Published by: couch.gb6585 on Jul 22, 2009
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02/05/2013

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Bullying Survey
Bullying is repeatedly and purposely hurting someone with less power. Bullying can be carried outwith words by threatening, taunting, teasing and calling names or when someone hits, kicks, pushesor retrains another by physical contact. It is also possible to bully without using words or makingphysical contact. This survey is provided in draft format by the Kansas State Department of Education and is being used with permission.
Bullying Questions
.5: What is your USD#?
Please write your answer here:
.6: What is your gender?
Please choose
only one
of the following:FemaleMale
.7: What grade are you in?
Please choose
only one
of the following:3rd4th5th6th7th8th9th10th11th12thStaff 
.8: How many different school districts have you attended since Kindergarten?
Please write your answer here:
1: Have you seen bullying at school?
Please choose
all
that applyNeverSometimes (1 or 2 times a month)Regularly (1 or 2 times a week)
 
Every day
2: How many times in the past year (the last 12 months) have you been bullied at school?
Please choose
all
that applyNeverSometimes (1 or 2 times a month)Regularly (1 or 2 times a week)Every day
3: How were you bullied?
Please choose
all
that applyI haven’t been bulliedI have been teased and called namesI have been hit, kicked or pushedOthers leave me out of their groupOthers have taken my belongingsOthers don’t sit by me or talk to meOthers say they will hurt meOthers try to hurt me on the way to and from schoolOthers bully me by phone or text message
4: How many kids have bullied you?
Please choose
all
that applyOne kid bullies meTwo or more bully meLots of kids bully me
5: During the past year how often did you miss school because you felt unsafe,uncomfortable or nervous at school or on your way to or from school?
Please choose
all
that applyNeverSometimes (1 or 2 times a month)Regularly (1 or 2 times a week)Every day
6: If you have seen bullying at school, what did you do?
Please choose
all
that applyI haven’t seen any bullying
 
Ignored it as none of my businessNothing, just watchedJoined in on the funTried to stop the bully or help the victimAsked for help from an adult or other student
7: If you have been or are being bullied, why do you think it happens?
Please choose
only one
of the following:No one bullies meI don’t know why others bully meI act or look differentI always do well in classI’m smaller or weakerI guess I deserve itOther
8: How many times in the past year have you bullied, teased or made fun of someone?
Please choose
only one
of the following:NeverSometimes (1 or 2 times a month)Regularly (1 or 2 times a week)Every day
9: Why are some kids bullies?
Please choose
only one
of the following:I don't knowThey are bigger and strongerThey think it is funThey want to get even for being bullied themselvesThey want to “show off” or impress their friendsThey fight in their own familiesOther
10: How many times in the past year (the last 12 months) have you had your propertystolen or deliberately damaged, such as your car, clothing, or books?
Please choose
only one
of the following:Never

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