SWISD Anti Harassment, Anti Bullying (AHA-B) Elementary Survey
To ensure our students have a safe, respectful learning community in which they can thrive, the Southwest Independent School District needs our students' feedback. These questions ask about your school and things that may or may not have happened to you at school. There are no right or wrong answers, and your response will not be shared with anyone. Do not add your name in any of your answers.
I attend school at this campus:
Are you a boy or a girl?
What is your race or ethnic background?
Required
Bullying Definition: This is a person who does mean things on purpose to hurt or embarrass you or someone else. The person does mean things over and over, not just once.
Choose ONE response.
During the past 12 months, how often have other students hit, pushed, or kicked you on purpose?
During the past 12 months, how often have other students said mean things, teased you, or called you names?
During the past 12 months, how often have other students ignored or did not include you in what they were doing?
During the past 12 months, how often have other students taken things that belonged to you without permission?
During the past 12 months, how often have other students threatened to hurt you?
During the past 12 months, how often have other students touched you in a way that made you feel uncomfortable, grabbed, or pinched you?
During the past 12 months, how often have other students bullied you through the internet, cell phone, or other electronic device?
If any of the mean things listed EVER happened to you, where did they take place? (Select all that apply.)
This question does not require a response.
If any of the mean things listed EVER happened to you, what did you do? (Select all that apply.)
This question does not require a response.
Are there adults at school who you can go to for help if someone is bullying you?
Are you comfortable going to your teacher(s) for help if someone is bullying you?
Do you feel safe at school?
Do you feel safe in the classroom?
Do you feel safe in the hallways?
Do you feel safe in the lunchroom?
Do you feel safe in the restroom?
Do you feel safe at recess or on the playground?
Do you feel safe at the bus stop near your home?
Do you feel safe in the area where you wait for the bus to pick you up from school?
Do you feel safe on the bus?
Do you feel safe going to and from school?
Next
Never submit passwords through Google Forms.
This form was created inside of Southwest ISD. Report Abuse - Terms of Service - Additional Terms