JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
PUE CAST Kindness Survey
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What is kindness?
*
Your answer
What does it mean to have character?
*
(good or bad character)
Your answer
How often do you see classmates doing kind acts for others?
*
everyday
a few times a week
not very often
never
What have you done for others that is kind?
*
Your answer
Has anyone been kind to you?
*
yes
no
Give an example of someone who is kind at the school (include names).
*
Your answer
Is bullying a problem at Pearl Upper?
*
yes
no
How often do you see someone being bullied at school?
*
everyday
a few times a week
not very often
never
Where does bullying most often occur?
*
during recess
in the cafeteria
in the hallway
during class
on the bus
before school starts
after school ends
Other:
Required
What type of bullying have you seen?
*
(not heard about)
physical bullying (hitting, pushing, tripping, kicking)
name calling
teasing
leaving others out
making mean faces, gestures, criticism of others
gossip, rumors, passing notes
none
Other:
Required
Would you tell an adult if someone was being bullied?
*
yes
no
If someone was bullying you, who would you most likely report the problem to?
*
Mr. Gill or Mrs. Scutch
teacher
family/parents
Nurse Julie
Mrs. Batson
Other:
Is there anyone at the school who constantly bullies you?
*
yes
no
What have you done about bullying?
*
Your answer
Who is your homeroom teacher?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report