Anti-Bullying Ambassador Programme
Baseline Survey 2018-2019

Background Information

Welcome to the Diana Award's Anti-Bullying Ambassador programme!

We want to find out a bit about you before we start so that we can see how much progress you've made by the end. Please ask your teacher if you're unsure about how to answer any of the questions.

Information you supply to us on this form will be used to improve our programmes. For further information see our privacy policy here: https://diana-award.org.uk/privacy/.

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* 1. Who is supporting your training?
(Please ask your teacher if you are unsure)

Department for Education

Facebook

Comic Relief

Zurich

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* 2. What is the name of your school?
Please use the full name of your school and not an abbreviation

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* 3. Which age group do you fall into?

Primary School (7-11 years old)

Secondary School (11-16 years old)

Sixth Form or College (16+ years old)

Other (please specify)

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* 4. In which country do you go to school?

England

Scotland

Wales

Northern Ireland

Other (please specify)

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* 5. What is your date of birth?

(dd/mm/yyyy)

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* 6. What best describes your gender?

Male

Female

Prefer not to say

Prefer to self-describe (please specify)

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* 7. What best describes your ethnicity?

White - British

White - Irish

White - Northern Irish

White - Irish traveller

White - any other white background

Mixed - White and Black Caribbean

Mixed - White and Black African

Mixed - White and Asian

Mixed - Any other mixed background

Asian/Asian British - Indian

Asian/Asian British - Pakistani

Asian/Asian British - Bangladeshi

Asian/Asian British - Chinese

Asian/Asian British - any other Asian background

Black/African/Caribbean/Black British - African

Black/African/Caribbean/Black British - Caribbean

Any other Black/African/Caribbean/Black British

Arab

Other (please specify)

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* 1. Who is supporting your training?(Please ask your teacher if you are unsure)

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* 2. What is the name of your school?Please use the full name of your school and not an abbreviation

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* 3. Which age group do you fall into?

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* 4. In which country do you go to school?

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* 5. What is your date of birth? (dd/mm/yyyy)

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* 6. What best describes your gender?

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* 7. What best describes your ethnicity?

* 1. Who is supporting your training?
(Please ask your teacher if you are unsure)

* 2. What is the name of your school?
Please use the full name of your school and not an abbreviation

* 5. What is your date of birth?

(dd/mm/yyyy)