Questionnaire

THE INTERFACE OF THEIR BULLYING EXPERIENCES AND SOCIAL

BEHAVIORS MANIFESTED AMONG THE BULLIED STUDENTS

Directions: Please accomplish this questionnaire by writing on the blanks provided for each
question the information required.

Part I. Respondents Profile

Name: (optional) ____________________________________

Age:

[ ] 17and below
[ ] 18 to 23
[ ] 24 to 29
[ ] 30 to 35
[ ] 36 to 41
[ ] 42 to 47
[ ] 48 to 53
[ ] 54 ad above

Gender:
[ ] Male
[ ] Female
[ ] Lesbian
[ ] Gay

Year level:
[ ] First Year
[ ] Second Year
[ ] Third Year
[ ] Fourth Year

Part II. Types of Bullying

Instruction: Read each of the statements below and put a / mark inside the box that best fits your
personal belief. This self-assessment is completed alone so that students can rate themselves
honestly without being concerned about comparisons. Be guided on the scoring procedure below.
 [5] Strongly Agree
[4] Agree
[3] Partially Agree/Disagree
[2] Disagree
[1] Strongly Disagree

S/N STATEMENTS SA A D SD
1 I don’t feel safe about bullying in school and in my
neighborhood because of the boys/girls there.
2 Bullying is a bad thing and I don’t like it
3 Someone can commit suicide due to bullying
4 I am aware of the bullying behaviours of students in my
school
5 There is no form of bullying behaviour among students in
my school
6 I sometimes don’t go to school because of the bullying in
my school
7 Sudden decrease in academic performance can be due to
bullying in school
8 Bullying in school doesn’t scare me it’s just an excuse for
failure
9 I hardly read my books in school because my friends will
laugh at me
10 Getting the best result has nothing to do with bullying
11 Bullying is the most common form of violence in my
school and it affect my academic performance
12 Bullying have a long-lasting detrimental effect on the
victim such as anti-social personalities, crimes, or suicide
13 Bullying always affect my study habit
14 Bullying affect my schedule for each term
Part II. Social Behavior

Instruction: Please tick (√) the option that constitutes bullying behavior in your school.

S/N ITEMS 1 2 2 4 5
1 Pinching
2 Mocking
3 Sexual harassing
4 Slapping
5 Verbal Attack
6 Extortion
7 Taking another learner’s belonging forcefully
8 Punching
9 Threatening
10 Humiliating

Research Questions was adopted from the study of Do Fareo (2015)