Sweet Home High School School Climate Survey 2012
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1. Grade Level
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2. Gender
3. I feel safe from physical harm, intimidation or threats.
4. I feel safe from persistent teasing; rumor spreading; cyber-bullying; or other behaviors that could be emotionally hurtful.
5. My teachers treat me with respect.
6. Other students treat me with respect.
7. Use of profanity (swear words) is a problem.
8. I have observed other students being bullied.
9. I have been bullied.
10. I have observed other students being harassed.
11. I have been harassed.
12. If you have been bullied or harassed, what methods were used?
13. If you have seen someone being bullied or harassed, why were they being targeted? Check all that apply.
14. I have participated in bullying or harassment in these ways.  Check all that apply. 
15. If I were being bullied or harassed at school, I would talk to a staff member (teacher, administrator, counselor, custodian, cook, etc) for help.
16. If I talk to staff members about these kinds of problems, I think they would listen and do things that help me feel supported.
17. There is a way (a form or procedure students know about) for reporting harassment or bullying at my school that I know how to use if I needed or wanted to report an incident.
18. When is bullying or harassment most likely to occur?
19. Where is bullying or harassment most likely to occur?  Check all that apply.