Bullying at the Middle Schoo;

Were you bullied by someone...

older than you

younger than you

we are the same age

What did you do when you were bullied?

told someone

did not tell anyone

stood up for yourself

withdrew from family and friends

bullied others

What does it mean to bully someone?

Other

Do you know the person that is bullying you?

yes

no

What types of bullying have you encountered?

hitting, kicking, shoving, tripping/physical bullying

called names/verbal bullying

Instagram/internet/cyberbullying

left out or excluded

threatened

property damaged

stolen property

I have not encountered bullying

How often do you hit, push, trip or shove another student?

1-2 times a week

3-5 times a week

6-8 times a week

9-11 times a week

I do not hit, push, trip or shove anyone.

How does bullying affect you?

Other

Comments/Suggestions:

Is there any action that your parents, teachers, counselors or principals could take to stop you from being bullied in the future?

Other

Who do you feel comfortable telling that you were bullied?