13. Have you repeatedly sent or received hurtful or threatening messages digitally (text, facebook, email, etc.): a. yes, I’ve sent them b. yes, I’ve received them c. I have both sent and received them d. no, I have not 14. Where is bullying most likely to take place? a. Hallway b. Classroom c. Locker room d. Cafeteria e. Bathroom f. Bus g. Other: Tell where: _________________________ 15. Are some areas of this school unsafe? a. no b. yes If so, tell _________________________ 16. What kinds of things have been done to you? Circle all that apply. a. Called names b. Threatened c. Something damaged or stolen d. Pushed, kicked, or hit e. Ignored or excluded f. Other, tell what: ________________________ 17. Was this bullying because of your: a. Race b. Religion c. Gender d. Age e. Ability f. Economic situation g. Residence (where you live) h. Perceived sexual orientation i. Other, tell what: ________________________
13. Have you repeatedly sent or received hurtful or threatening messages digitally (text, facebook, email, etc.): a. yes, I’ve sent them b. yes, I’ve received them c. I have both sent and received them d. no, I have not 14. Where is bullying most likely to take place? a. Hallway b. Classroom c. Locker room d. Cafeteria e. Bathroom f. Bus g. Other: Tell where: _________________________ 15. Are some areas of this school unsafe? a. no b. yes If so, tell _________________________ 16. What kinds of things have been done to you? Circle all that apply. a. Called names b. Threatened c. Something damaged or stolen d. Pushed, kicked, or hit e. Ignored or excluded f. Other, tell what: ________________________ 17. Was this bullying because of your: a. Race b. Religion c. Gender d. Age e. Ability f. Economic situation g. Residence (where you live) h. Perceived sexual orientation i. Other, tell what: ________________________
SJYA-bullying-advance-questionnaire.docx