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Exit Survey
 
 
Are you:
 
Male
 
Female
 
Other
 
 
 
 
How old are you?
 
12-15
 
16-18
 
19-21
 
22-25+
 
 
 
Have you been bullied?
 
Yes
 
No
 
 
 
Have you ever witnessed bullying?
 
Yes
 
No
 
 
 
If Yes, Did you do anything to help?
 
Yes
 
No
 
 
 
If you were bullied, what was it for?
 
Glasses
 
A disability
 
Different race or Religion
 
Gay or Lesbian
 
Relationship Issues
 
Don't know
 
Other
 

 
 
 
Who Bullied you?
 
Family
 
Friends
 
Co-Workers
 
Boss
 
Other
 

 
 
 
Where were you bullied?
 
School
 
Work
 
Home
 
Other
 

 
 
 
Teens do not show up to school because of Bullying
 
True
 
False
 
 
 
Do you think anything in your opinion is being done about bullying.? Yes or No?