Middle School Bullying Survey - 6th

Bullying is an aggressive, on-gong behavior that is intentional and involves an imbalance of power or strength. Bullying can take various forms, including: 1) physical bullying - hitting or pushing, 2) verbal bullying - teasing or name-calling, 3) emotional bullying - intimidation using gestures or being deliberately left out, and/or 4) cyber-bullying - sending insulting messages by cell phone or computer e-mail.

In order to combat the problem of bullying, the adults in your school and in your community would like to know about bullying at your school. When answering the questions below, please think about any bullying activity that you have been involved in or witnessed during the present school year.


  1. Which school do you attend?
    PMMS
    NFMS
    SKMS


  1. What grade are you in?
    6
    7
    8


  1. Are you male or female?
    Male
    Female


  1. Have you ever been the victim of bullying while at school?
    Yes
    No


  1. If you answered Yes to question 4, where did this bullying occur?
    Bus
    Hallway
    Bathroom
    Classroom
    Cafeteria
    Before or after school


  1. If you answered Yes to question 4, what type of bullying did you experience?
    Physical bullying
    Verbal bullying
    Emotional bullying
    Cyber-bullying


  1. If you answered Yes to question 4, has this bullying been a problem since elementary school, or did this just begin in middle school?
    On-going since elementary school
    New in middle school


  1. If you answered Yes to question 4, were there adults around while the bullying was happening?
    Yes
    No


  1. If adults were around, did they do anything to stop the bullying?
    Yes
    No


  1. If you have been bullied, have you ever told an adult that you were being bullied?
    Yes
    No


  1. If you reported bullying to an adult, did the bullying stop or get worse after you told?
    Bullying stopped
    Bullying got worse


  1. If you have been bullied, have you ever told your parent that you were being bullied?
    Yes
    No


  1. If you reported bullying to a parent, did the bullying stop or get worse after you told?
    Bullying stopped
    Bullying got worse


  1. Have you ever been bullied so badly that you did not want or were scared to come to school?
    Yes
    No


  1. If you have been bullied, describe the bully or bullies, and the situation. (Check all that apply.)
    A single bully
    A group of bullies
    By myself
    Other students or adults were around.
    Someone stood up for me.


  1. Have you ever seen another student being bullied?
    Yes
    No


  1. If you have seen bullying, where did this bullying occur?
    Bus
    Hallway
    Bathroom
    Classroom
    Cafeteria
    Before or after school


  1. If you have seen bullying, what type of bullying did you observe?
    Physical bullying
    Verbal bullying
    Emotional bullying
    Cyber-bullying


  1. If you have seen bullying, were there adults around when the bullying happened?
    Yes
    No


  1. Have you ever bullied another student?
    Yes
    No


  1. If you have bullied another student, where did this bullying occur?
    Bus
    Hallway
    Bathroom
    Classroom
    Cafeteria
    Before or after school


  1. If you have bullied another student, what type of bullying did you use?
    Physical bullying
    Verbal bullying
    Emotional bullying
    Cyber-bullying


  1. If you have bullied another student, have you been repeatedly bullying the same student, or do you bully numerous students?
    Same student
    Numerous students


  1. If you have bullied other students, have you done so since elementary school, or did this just begin in middle school?
    Since elementary school
    Started in middle school


  1. If you have bullied another student, were there adults around at the time?
    Yes
    No


  1. If you have bullied other students, were they (Check all that apply.)
    Younger than you
    Smaller than you
    Students who dress differently than you
    From a different racial or ethnic group
    The same sex as you
    The opposite sex


  1. What do you think can be done to prevent bullying at your school? Please type your response in the box below.