QUESTIONAIRES
QUESTIONAIRES
Name: __________________________________________________(optional)
________Male ________Female
________Single ________Widowed/Widower
________Married ________Others (pls. specify)
Educational Attainment
_______BACHELOR OF ELEMENTARY EDUCATION
_______With MA Units
_______MA graduate
_______With Doctoral Units
_______Doctorate Graduate
5 - Highly Evident
4 - Evident
3 - Moderately Evident
2 - Less Evident
1 - Not Evident
Physical Bullying 5 4 3 2 1
1. Damaging and or stealing someone’s property
like books, bags etc.
2. Kicking
3. Punching
4. Shoving
5. Hitting on something
6. Stepping on feet.
7. Tripping.
8. Slapping on face.
9. Pushing
10. Making mean or rude hand gestures.
Verbal Bullying
1. Teasing someone about their physical
appearance, disabilities and indifferences.
2. Calling someone a mean name.
3. Making offensive remarks or joking about a
person’s religion, ethnicity, socioeconomic status
or the way they look.
4. Making inappropriate sexual comments about
someone’s gender and sexual orientation.
5. Making cruel criticism to someone resulting
him/her to be intimidated.
6. Using sarcasm to be mean.
7. Insulting when someone is asking questions.
8. Threatening to follow someone’s command.
9. Tormenting on someone’s negative looks.
10. Taunting to make someone angry.
Social Bullying
1. Damaging someone’s reputation or social
acceptance.
2. Lying and spreading false rumors.
3. Portraying negative facial or physical gestures,
menacing or contemptuous looks.
4. Playing a nasty jokes to embarrass and humiliate
someone in public.
5. Leaving someone out on purpose.
6. Excluding someone in a group and/or social
rejection.
7. Telling other children not to be friends with
someone.
8. Intimidating someone in front of her/his peers.
9. Making a scene to embarrass someone in public.
10. Mistreating someone in front of others.
Cyber Bullying
1. Sending harmful text messages.
2. Making fun of somebody via social network
3. Imitating others online or using their log-in.
4. Using name calling in posting pictures social
media.
5. Making repetitive and abusive phone calls.
6. Posting embarrassing videos and asking friends
to make funny comments.
7. Using other face book account to harm others.
8. Using profile picture of somebody to chat
foreigners.
9. Spreading rumors about someone using social
networking sites.
10. Cursing and using vulgar language sent to
someone’s social media account.
Part II
Directions: Below are lists of effects of bullying in different life aspects. State your
assessment on the level of extent of these effects by checking appropriate column. Be
guided by the rating scale below.
2 Low Extent
1 No Extent