PART 1

Questionnaire
Personal Information Sheet:
School:__________________ Age:
Sex: ( ) Male Year level: ( ) Grade 4
( ) Female ( ) Grade 5
( ) Grade 6

Research Tool for Level of Awareness on the Implementation of Anti-Bullying Policies,

University Grade School
Direction: Please put a check on the space provided indicating your level of awareness
of the anti-bullying policies and experiences.
Value Level of Description Interpretation
Implementation
4 Fully The statement Highly Aware
Implemented happens at least
twice a year with
clear and specific
explanation
3 Moderately The statement Moderately Aware
Implemented happens at least
twice a year with a
brief explanation
2 Implemented The statement Aware
happens at least
once a year
1 Not Implemented The statement was Not Aware
not implemented at
all.
PART II.
Level of Awareness Highly Moderately Less Not
Aware Aware Aware Aware
(4) (3) (2) (1)
1. My school gives thorough orientation on the
anti-bullying policies of the school.
2. My school circulated leaflets and learning
materials on anti-bullying during and after
orientation.
3. My school is persistent on implementing the
policy by circulating and explaining guidelines on
anti-bullying.
4. My school provides a help desk on anti-bullying.
5. My school is attentive on the aftercare of bullies
and bullied.
6. My school provides full support on advocacies
on anti- bullying in the community or outside the
community.
7. My school provides orientation on bullying to
parents.
8.My school has a Child Protection committee to
assure that all school policies to Child protection
and Anti-Bullying are fully implemented.
9. My school has guidance programs and activities
that would address problems on bullying.
10. My school embeds the anti-bullying policies
clearly in the handbook.
11. My school has incorporated bullying in lessons
when appropriate.
12. My school does not encourage corporal
punishment as a form of training, discipline or
control.
13. My school maintains an environment of care
and trust in the classroom.
14. My school supports students who are bullies
and helps restore lost confidence and self-esteem.
15. My school maintains a positive and nonviolent
mode of disciplining children to improve their self-
confidence and self-respect.
16. My school ensures that the appropriate
interventions, counselling, and other services are
provided for the victims of abuse, violence,
exploitation, discrimination, and bullying.
Others, please specify.

PART III : Perceived Effects of Bullying

Direction: Please put a check on the space provided indicating your level of
manifestation of the anti-bullying policies and experiences.
Value Level of Description Interpretation
manifestation
4 Greatly The statement Greatly
manifested happens everyday manifested
with clear and
specific
explanation.
3 Moderately The statement Moderately
manifested happens at least manifested
twice a month with
a brief explanation.
2 Less manifested The statement Less manifested
happens at least
once a year.
1 Not manifested The statement was Not manifested
not manifested at
all.

4. Greatly Manifested 2. Less Manifested

3. Moderately Manifested 1. Not Manifested

Items 4 3 2 1

1.suicide

2. dislike for schooling (not interested to go to school)

3.social isolation

4. feeling of shame
5.sleep disturbance

6. changes in eating habits

7. low self-esteem

8. symptoms of anxiety

9. poor school performance

10. symptoms of depression

11. no self-respect

12. becoming aggressive against others

Others, please specify.