o Others snatch my lunch and other

belongings
NAME:(Optional)_______________________
o No one talks to me in school
YR/SEC._________ Age:_______ Sex_______
Date:_________
Instruction: The main objective of this sample
survey is to find out the factors affecting
Bullying in the students in Naguilian Senior High o I have been sent threat warnings
School. o Other
1.What year are you in? 7.In this academic year how many days have
you missed school because you felt unsafe to
o Year 11
show up to school?
o Year 12
o Never
2.What is your gender?
o 1 or 2 times a week
o Female o 1 or 2 times a month
o Male o 1 or 2 times a 3 months
o Other o 1 or 2 times a 6 months
o Everyday
3.Bulliying is a problem in our community
8.If you saw someone being bullied at school
o Strongly Agree
would you-
o Agree
o Disagree o Do nothing
o Don’t know o Take matters in your own hand
o Report to school authorities
4.Do you feel safe at school? o Tell your parents
o Never o Call the police
o Sometimes
9.Have you talked to anyone about being
o Often bullied?
5.During this academic session how many times o I haven’t been bullied
have you been bullied? o No, I am scared I will be judged
o Never o Yes, I have expressed my concerns to
o Sometimes (1 or 2 times a month) my parents
o Regularly (1 or 2 times a week) o Yes, I have expressed my concerns to
o Everyday my teachers
o Yes, I have expressed my concerns to
6.Can you tell us how were you bullied? my friends
o Yes, I have expressed my concerns to
o I haven’t been bullied
my siblings
o I have been kept names
o I have been physically assaulted 10.What can the school do to stop bullying?
o I don’t get to sit on any of the tables
during lunch hour o Supervise the school better
o Make rules against bullying
o Talk about bullying during class
o Bullying is not a problem in my school

Group Member: Mar Guiliane Gamulo

Angelo Aberin
Rhaven Astucia
Menbhill Andrada