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DIRECTIONS: Please circle or underline the best answers to the following questions. You may have more than one best answer for some questions. You do not have to put your name on the paper.
Name (optional)__________________
1. Have you ever been bullied?
Yes No
2. Have you seen other students being bullied at school?
Yes No
4. How much of a problem is bullying for you?
Very much Not much None
5. On the back of this paper, list some of the actions you think parents, teachers, and other adults could perform to stop bullying.
Adapted from a survey by The National Crime Prevention Council.
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