Harassment Experiences of Teachers

Age: _____________ Sex: _________ Rank/Position: _________________________________

Name & Address of the School: ___________________________________________________________
Type of School: Private Government
Level: Elementary High School Tertiary
Number of years in service: _______________

1. Have you experienced harassment from student/s? Yes No

If yes, what form of harassment? _________________________
What was the issue? Kindly describe. E.g. grades, enrolment, etc.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What was your dilemma?
_____________________________________________________________________________________
What was the effect of the situation on your
a) Emotional stability? __________________________________________________________________
b) Professional stability? _________________________________________________________________
c) Self-worth? _________________________________________________________________________
How did you address the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________
What was the action of your immediate superior on the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Have you experienced harassment from parent/s? Yes No
If yes, what form of harassment? _________________________
What was the issue? Kindly describe. E.g. grades, enrolment, etc.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What was your dilemma?
_____________________________________________________________________________________
What was the effect of the situation on your
a) Emotional stability? __________________________________________________________________
b) Professional stability? _________________________________________________________________
c) Self-worth? _________________________________________________________________________
How did you address the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________
What was the action of your immediate superior on the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________
3. Have you experienced harassment from government official/s? Yes No
If yes, what form of harassment? _________________________
What was the issue? Kindly describe. E.g. grades, enrolment, etc.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What was your dilemma?
_____________________________________________________________________________________
What was the effect of the situation on your
a) Emotional stability? __________________________________________________________________
b) Professional stability? _________________________________________________________________
c) Self-worth? _________________________________________________________________________
How did you address the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________
What was the action of your immediate superior on the issue?
_____________________________________________________________________________________
_____________________________________________________________________________________