SURVEY Bullying Buddy Survey Please fill out the survey below, it should take no longer than 3-4 minutes of your time. Thanks in advance! What is your name? What school year are you in? 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th-12th Grade Other: State other Gender Female Male Prefer not to say Bullying is a problem in our community/schools. Agree Disagree Strongly Disagree Don't Know Do you feel safe at school? Never Sometimes Often Always During this school year, how often have you seen someone being bullied? Never Sometimes Often Always If you believe bullying is a problem, where does it most often occur? (Check all that apply) Before School On the way to school Between Lessons During Lessons After School Other: State other Who do you talk to when you have problems at school? Parent Guardian Sibling Counselor Administrator Teacher Other: State other Have you been bullied by other students in the last year (Bullying meaning, a repeated act, or continuous of one of the following)? Physical Verbal Social Cyber Racial Gender I haven't been bullied Have you seen or heard another student being bullied in the last year? Physical Verbal Social Cyber Racial Gender I haven't been bullied During the past year, how often did you miss school because you felt unsafe, uncomfortable, or nervous? Never Sometimes (1 or 2 times a month) Regulary (1 or 2 times a week) Every day If you have seen bullying at school, what did you do? I haven't seen any bullying Ignored (it's none of my business) Nothing (just watched) Join in on the fun Tried to stop the bully/help Asked for help from an adult or other student Other: State other If you have been or are being bullied, why do you think it happens? No one bully's me I don't know why others bully me I act or look different I always do well in class I'm smaller or weaker I guess I deserve it State other Why are some kids bullies? I don't know They are bigger and stronger They think it is fun They want to get even for being bullied themselves They want to; show off; or impress their friends They are in the ‘popular’ group They fight in their own families Other: State other What do adults do at school when they see bullying? Nothing, they ignore it Stop it and tell everyone to leave Stop it and solve the problem Other: State other Have you tested positive or anyone in your family for Covid-19? Yes No Haven't been tested Other: State other Has Covid-19 made you feel depressed or angry? Yes No Other Have you or someone in your family been vaccinated? Yes No Other How do you feel about wearing a mask in school? Strongly agree Agree Neutral Disagree Strongly Disagree Submit
