Personal information

Name (Optional): _______________________________________

Please encircle your answer to the following question.
a) Male b) Female
Age:
a) Under b) 16-18 c) 19-20 d) Over 20
Information on bullying
1. Do you bully?
a) Yes b) No
2. If yes, why do you bully?
a) Recreational purposes
b) Stress relief
c) Other: please specify
3. Which kind bully is least harmful?
a) Physical
b) Verbal
4. Are you aware of the negative impacts of bullying?
a) Yes
b) No
Specify such impact______________________________________________________
5. Are you aware of the fact that bullying destroys life of millions of people per year?
a) Yes
b) No
6. Do you think bullying should be solved?
a) Yes
b) No
Please explain your answer:
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7. What do you think are the possible effects of bullying?

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