My Life in School Checklist

We would like to know what happens to people in school. I this survey are various things that might have happened to you during the last week. You should work individually and not share your answers with other people.


  1. Grade
    6th grade
    7th grade
    8th grade


  1. Sex
    Male
    Female


  1. This week another student called me names.
    Never
    Once
    More than once


  1. This week another student said something nice to me.
    Never
    Once
    More than once


  1. This week another student was nasty about my family.
    Never
    Once
    More than once


  1. This week another student kicked me or hit me.
    Never
    Once
    More than once


  1. This week another student was very nice to me.
    Never
    Once
    More than once


  1. This week another student was unkind to me.
    Never
    Once
    More than once


  1. This week another student shared something with me.
    Never
    Once
    More than once


  1. This week another student said they would beat me up.
    Never
    Once
    More than once


  1. This week another student asked me for lunch/snacks.
    Never
    Once
    More than once


  1. This week another student tried to make me give them money.
    Never
    Once
    More than once


  1. This week another student frightened me.
    Never
    Once
    More than once


  1. This week another student played with me.
    Never
    Once
    More than once


  1. This week another student stopped me playing a game.
    Never
    Once
    More than once


  1. This week another student laughed at me.
    Never
    Once
    More than once


  1. This week another student made me fight.
    Never
    Once
    More than once


  1. This week another student smiled at me.
    Never
    Once
    More than once


  1. This week another student tried to get me in trouble.
    Never
    Once
    More than once


  1. This week another student helped me.
    Never
    Once
    More than once


  1. This week another student told me a joke.
    Never
    Once
    More than once


  1. This week another student played a nice game with me.
    Never
    Once
    More than once


  1. This week another student hurt me or tried to hurt me.
    Never
    Once
    More than once


  1. This week another student Chatted with me.
    Never
    Once
    More than once


  1. This week another student stole something from me.
    Never
    Once
    More than once


  1. This week another student was rude about the way I looked.
    Never
    Once
    More than once


  1. This week another student shouted at me.
    Never
    Once
    More than once


  1. This week another student tripped me.
    Never
    Once
    More than once


  1. This week another student said they would tell on me.
    Never
    Once
    More than once


  1. This week another student spoiled my work.
    Never
    Once
    More than once


  1. This week another student hid something of mine.
    Never
    Once
    More than once


  1. This week another student told a lie about me.
    Never
    Once
    More than once


  1. This week another student helped me with my work.
    Never
    Once
    More than once


  1. This week another student laughed at me.
    Never
    Once
    More than once


  1. This week another student made me laugh.
    Never
    Once
    More than once


  1. This week another student tried to break something of mine.
    Never
    Once
    More than once


  1. This week another student gave me something nice.
    Never
    Once
    More than once


  1. This week another student tried to hit me.
    Never
    Once
    More than once


  1. This week another student said they liked me.
    Never
    Once
    More than once


  1. Think of the unfriendly incident that upset you most. Was the person that did this:
    in your grade
    younger
    older
    I've had no unfriendly incident.


  1. Think of the unfriendly incident that upset you most. Where did it happen?
    classroom
    bathroom
    hallway
    outside the school
    bus
    elsewhere
    I've had no unfriendly incident.


  1. Think of the unfriendly incident that upset you most. Did you tell a member of the staff?
    yes
    no
    I've had no unfriendly incident.


  1. If you did tell someone, did it help?
    yes
    no
    I've had no unfriendly incident.


  1. Think of the unfriendly incident that upset you most. Did you tell your parents?
    yes
    no
    I've had no unfriendly incident.


  1. Should the school do more to stop this sort of thing?
    yes
    no
    I've had no unfriendly incident.





Mr. B
Sussex County Charter School for Technology