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Bullying Survey
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* Indicates required question
What is your gender?
*
Male
Female
What school do you attend?
*
Choose
Tallulah Elementary
Wright Elementary
Madison Middle
Madison High
Christian Acres
Madison Parish Alternative
Do you feel safe at school?
*
Yes
No
Do you feel safe on your way to school?
*
Yes
No
Do you feel safe on your way home from school?
*
Yes
No
Do other students say things to hurt your feelings?
*
Yes
No
Where are you bullied?
*
Playground
Classroom
Restroom
Cafeteria
Gym
Bus
I am not being bullied
Required
Have you ever told your teacher about being bullied?
*
Yes
No
N/A
How often does your teacher do something?
*
Always
Sometimes
Never
N/A
Have you ever tried to help someone else who was being bullied?
*
Yes
No
If you have additional comments, type them below.
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