1. Please specify your gender. Male Female
2. What is your age?
3. have you experienced cyber bullying? Yes No Can't Say
4. when have you experienced cyber bullying or seen bullying?
5. Have you been sent any hateful, discriminating, racist messages via IM, Texts, emails or social media venues? If Yes, tick all venues that apply IM Text Messages Facebook Twitter Ask Myspace Other, please specify
6. How did you act when you received these messages? click more than one if applies Ignored it Reported to teacher/parents Reported to social media Reported to Internet Confronted the sender Blocked the sender Other, please specify
7. Do you believe social media sites such as Facebook, Twitter, Ask, Myspace and such are doing enough to prevent Cyber Bullying? Yes Not Enough No, Could do more Not even close
8. Choose what information you believe can safely be shared online? Feel free to tick as much as you want. Address Family Members Your Location where you going Photos
9. Do schools help when Cyber Bullying happens? Yes No Can't Say
10. Do you feel the event was resolved successfully? Why or why not?
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