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* 1. The name of my child’s school or college is:

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* 2. My child is in year:

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* 3. I am the child’s:

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* 4. Has your child been bullied in school during the last 12 months? PLEASE TICK ONLY ONE BOX (If you answer ‘No’, ‘Not sure’ or ‘Prefer not to say’ please go straight to Question 12)

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* 5. When did the bullying last happen? PLEASE TICK ONLY ONE BOX

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* 6. What kind of bullying was it? PLEASE TICK ALL THAT ARE TRUE FOR YOUR CHILD

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* 7. Would you describe the bullying in any of the following ways? PLEASE TICK ALL THAT ARE TRUE FOR YOU

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* 8. Where does your child say that the bullying usually happens? PLEASE TICK ALL THAT APPLY

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* 9. Did you report the bullying to anyone in the school?

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* 10. Who did you report the bullying to?

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* 11. What happened after reporting the bullying? PLEASE TICK ONLY ONE BOX

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* 12. How confident are you that your child’s school deals well with bullying? PLEASE TICK ONLY ONE BOX

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* 13. How confident are you that your child’s school would listen if either you or your child had concerns about bullying? PLEASE TICK ONLY ONE BOX

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* 14. Who would you tell if you were worried that your child was being bullied at school? PLEASE TICK ALL THAT ARE TRUE FOR YOU

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* 15. Have you received or seen a copy of the school’s Anti-Bullying Policy? PLEASE TICK ONE BOX ONLY

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* 16. What do you think would prevent bullying in your child’s school? PLEASE TICK UP TO THREE BOXES

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* 17. Has your child been bullied in your community during the last 12 months? (If you answer ‘No’, ‘Not sure’ or ‘Prefer not to say’ please go straight to Question 22)

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* 18. When did the bullying last happen?

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* 19. Where did the bullying happen? PLEASE TICK ALL THAT APPLY

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* 20. What type of bullying was it? PLEASE TICK ALL THAT APPLY

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* 21. Would you describe the bullying in any of the following ways? PLEASE TICK ALL THAT APPLY

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* 22. Who would you tell if your child was being bullied In the community? PLEASE TICK ALL THAT ARE TRUE FOR YOU

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* 23. What do you think are the best ways to make bullying stop in the community? PLEASE PICK UP TO THREE ANSWERS

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