Student ID Number
Gender
This child hits, pushes, or shoves peers
This child snatches objects from his or her peers
This child says mean things to peers, such as teasing or name calling
This child verbally threatens their peers
This child starts fights with peers
This child threatens or bullies others in order to get his or her own way
This child gets other kids to gang up on a peer that he or she does not like
This child tells peers not to play with other peers, who are present
This child tells peers not to play with other peers, who are not present
This child tries to get others to dislike another peer, who is not present