Middle School Bullying Survey
Gender: _____ Grade:_____
Bullying is someone who repeatedly hits, punches, teases, excludes, or intimidates another person. Bullying is a repeated action that happens over a period of time. There are six different types of bullying listed. Please put them in order based on which ones you see or experience the most at Stuarts Draft Middle School.
(1-The most often; 6-Least often)
□ Name calling
□ Hitting, kicking, or pushing
□ Leaving someone out of the group
□ Spreading rumors
□ Threatening face-to-face or through written notes
□ Cyberbullying (Facebook or text messages)
Please list any other bullying situations that you’ve seen or experienced at Stuarts Draft Middle School.
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Bullying is someone who repeatedly hits, punches, teases, excludes, or intimidates another person. Bullying is a repeated action that happens over a period of time. There are six different types of bullying listed. Please put them in order based on which ones you see or experience the most at Stuarts Draft Middle School.
(1-The most often; 6-Least often)
□ Name calling
□ Hitting, kicking, or pushing
□ Leaving someone out of the group
□ Spreading rumors
□ Threatening face-to-face or through written notes
□ Cyberbullying (Facebook or text messages)
Please list any other bullying situations that you’ve seen or experienced at Stuarts Draft Middle School.
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________