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1. We want to hear from you!

If you have ever been bullied, we want to hear from you! Your opinions are important! Responses are confidential, so we cannot respond through the survey. If you or someone you know needs help, please email bullying411@pacer.org and someone will respond to your request.

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* 1. Which state or country do you live in?

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* 2. Pick one that best describes where you live.

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* 3. Choose which best describes your school.

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* 4. Does your school have a bullying prevention program?

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* 5. What grade are you in?

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* 6. Where did the bullying occur? (check all that apply)

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* 7. What kind of bullying have you experienced? (check all that apply)

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* 8. Was the person(s) bullying you? (check all that apply)

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* 9. Was the bullying about any of the following? (check all that apply)

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* 10. What did you do in response? (check all that apply?)

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* 11. What would help you to address bullying?

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* 12. Anything else you want to share?

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