MDJH School Safety Survey

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The Green Apple Alliance of MacDonald Drive Junior High is conducting a student survey about bullying and related experiences in the school environment. Your answers will help the Alliance develop and provide programs and initiatives to support our student’s needs and ensure a positive & respectful school for all. The survey should take about 5-10 minutes to complete and all answers are anonymous and confidential.

Section 1

Directions: Below is a series of statements about different experiences students may have in the school environment. For each statement, please indicate how often these experiences occur to you while at school.

I have been called insulting names by others.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced uninvited physical contact such as hitting, pushing, or tripping, that made me feel intimidated,.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have been threatened with physical harm.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have had hurtful rumours spread about me at school.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my race or nationality.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my religion or spiritual beliefs.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my social class, such how much money my family has, my cloths, or where I live.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my appearance, such as my height, my weight, or how I look.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced situations where others have forced me, or tried to force me, to give them money or other items of personal property.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced threats or insults from others through cell phone, social media or other online medium.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced uninvited touching that made me feel uncomfortable.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced uninvited comments of a sexual nature.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my sexual orientation.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have heard insulting comments about my gender identity.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

I have experienced a negative impact on my learning as a result of other students disrupting my classes.

Regularly

Often

Sometimes

Rarely

Never

Clear selection

Clear form

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