Cooper 4th Grade Bully Prevention Student Survey

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Here are some questions about being bullied by other students. We say a student is being bullied when another person, 1. says mean or hurtful things or makes fun of him or her or calls him or her mean and hurtful names, 2. completely ignores or excludes him or her from their group of friends or leaves him or her out of things on purpose, 3. hits, kicks, pushes, shoves around or locks him or her inside a room, 4. tells lies or spreads false rumors about him or her or sends mean notes and tries to make other students dislike him or her.

When we talk about bullying, these things happen repeatedly and it is difficult for the student being bullied to defend himself or herself. We also call it bullying, when a student is teased repeatedly in a mean and hurtful way. We don't call it bullying when the teasing is done in a friendly and playful way. Also, it is not bullying when two students of about equal strength or power argue or fight.

1. Are you a boy or a girl? *

Boy

Girl

2. What grade are you in? *

3rd Grade

4th Grade

5th Grade

3. I was bullied and called mean names, made fun of, or teased in a hurtful way. *

Yes

4. I was bullied by being left out of things on purpose or completely ignored. *

Yes

5. I was bullied by being pushed, hit or kicked. *

Yes

6. I was bullied by other students telling lies or spreading rumors about me. *

Yes

7. I was bullied by having things taken away or damaged. *

Yes

8. I was bullied by being threatened or forced to do things I didn't want to do. *

Yes

9. I was bullied with mean names or comments about my race or color. *

Yes

10. I was bullied with mean names, comments or gestures with a sexual meaning. *

Yes

11. Where have you been bullied? *

I haven't been bullied.

Playground

Hallways

In class with an adult present

In class without an adult present

Required

12. Who have you told that you have been bullied at school in the past couple of months? *

I haven't been bullied at school.

No one

Classroom teacher

Another adult at school

Your parents or guardians

Required

13. How often do the adults at school try to put a stop to bullying? *

Almost never

Sometimes

Almost always

14. How often do other students try to put a stop to bullying? *

Almost never

Sometimes

Almost always

15. How have you bullied at school in the past couple of months? *

I called other student(s) mean names, made fun of them or teased them in a hurtful way.

I left others out on purpose or completely ignored them.

I hit, kicked or pushed other students.

I told lies or spread rumors about other students.

I took things away from other students or damaged them.

I threatened or forced other students to do things they didn't want to do.

I called other students mean names or made comments about their race or color.

I called other students mean names or made gestures with a sexual meaning.

I did not bully.

Required

16. When you see a student being bullied at school, what do you think or feel? *

That he or she probably deserves it.

I don't feel much.

I feel a bit sorry for him or her.

I feel sorry for him or her and want to help.

17. How do you react when you see bullying at school? *

I haven't seen bullying.

I join the bullying.

I don't do anything, but I think the bullying is okay.

I don't do anything, but I think I ought to help the bullied student.

I try to stop the bullying.

18. Are you afraid of being bullied at school? *

Yes

19. How often do you have classroom meetings? *

Never

Once or twice every month

Every week

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