Student School Violence Survey Template

Student sentiment towards safety on a school campus.


You are invited to participate in our survey. The purpose of this questionnaire is to understand your experience as a student of this school regarding the violence that you heard of, witnessed or experienced in the school environment in the last academic semester/year.

The survey takes approximately 15 minutes to complete.

Please take some moments to reflect on each question addressed and try to be as sincere and specific as possible. Your answers will be treated with confidentiality and they will be used for improvement purposes only.  

Thank you for your cooperation!
* Your school's name is:
* You are a:
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?
Once or twice
Three to five times
Six to ten times
More than ten times

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