Student School Violence Survey Template

Student School Violence Survey Template by QuestionPro is designed to collect feedback from students going to school regarding the violence that you heard of, witnessed or experienced in the school environment in the last academic semester/year. In this sample survey template, students are asked questions regarding their school environment and how safe they feel. In this questionnaire, students are asked about the sentiments of students regarding their safety in their school campus. This survey has a total of 23 questions added with an aim to understand child safety against violence.


 
 
* Your school's name is:
   
 
 
* You are a:
 
Female
 
Male
 
Other / I prefer not to respond
 
 
* Your current grade level:
 
 
*

How frequently do you consider the manifestations of violence among students happen in your school?


 
Once a year or less
 
More than once a year
 
More than once a month
 
More than once a week
 
Every time
 
How would you describe your school?
Strongly disagree Disagree Neither disagree nor agree Agree Strongly agree
* My school building is generally clean
* Many things are broken or damaged at my school (e.g., the windows, the computers, the outdoor equipment)
* Areas in or around my school have a good night lighting
* My school has specialized staff for preventing violence inside of its environment
* Teachers seem prepared to react appropriately in case of violence manifestation in our school environment
* We are all (teachers, students, and other staff) trained on how to react when a violence manifestation happens in our school.
* There are many bullies in my school.
 
How would you rate your own experience with violence in this school, in the last academic semester/year?
Strongly disagree Disagree Neither disagree nor agree Agree Strongly agree
* I felt safe at my school.
* I felt safe on my way to and from school.
* I was bullied in school by another student.
* Some other student might felt bullied by myself.
* I felt aggressed by a teacher or other staff of the school.
* When another student was involved in unsafe or dangerous behavior I reported that anonymously (without anyone knowing it was me).
* When another student was bullied by another or by someone from outside the school, I intervened to stop that.
* Sometimes, I have judged people from my school based on their racial characteristics.
* I have been exposed to violence at home due to school issues (e.g. grades, conflicts with my colleagues etc.).
 
 
How would you describe violence in school? Please, give us some examples. (Optional)
   
 
 
* During the past school semester/year, for how many times did you intentioned or even ended up staying home from school because you were afraid you would not be safe at school?
 
Never
 
Once or twice
 
Three to five times
 
Six to ten times
 
More than ten times

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