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KY One-Bethlehem High School-Spring 2017 Survey-Abbreviated KIP for Baseline

This question requires a valid date format of MM/DD/YYYY.
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4. How old are you? 
5. What grade are you in? 
6. Are you: 
7. Are you Hispanic or Latino? 
8. What is your race? (Select one or more responses if necessary.) 
9. Is anyone in your family (or someone close to you) currently serving on active duty or retired/separated from the Armed Forces, the Reserves, or the National Guard? 
10. Do you think fights between students of different racial and/or ethnic backgrounds is a problem at your schol? 
11. During the last school year, did someone verbally threaten you at school? 
12. During the last school year, did someone physically threaten, attack or hurt you at school? 
13. During the last school year, did someone make unwanted sexual advances or attempt to sexually assault you at school? 
14. During the last school year, did a boyfriend or girlfriend physically hurt you (hit, push, pull your hair) on purpose? 
15. During the last school year, did a boyfriend or girlfriend emotionally hurt you (threaten, make threatening phone calls/texts, call you names, harass you online) on purpose? 
16. During the past year (12 months), have you been bullied on school property? 
17. During the past year (12 months), have you ever been electronically bullied (include being bullied through e-mail, chat rooms, instant messaging, websites, social networks, or texting)? 
18. In the past 12 months, has your drinking and/or drug use caused you to get into fights, verbally or physically, with other kids? 
19. At what age (if ever) did you first attack someone with the idea of seriously hurting them? 
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