Come Home Safe Program

2010 Winners:

Thanks to everyone who participated in the 2009/2010 Come Home Safe project. Winners of the monetary incentives were:

Wahoo High School: $500

Marion High School: $500

Howells-Clarkson High School: $1000

While the project is complete for the 2009/2010 school year, it remains important for all students and everyone to buckle up, every trip, every time.

School Information

School Name: Address: City: State: Zip: Phone: Fax: Email: Principal: Contact Name: Contact Title: Contact Email: Contact Phone: Contact Fax:

Safety Belt Usage

Enter the results of two unannounced observational surveys conducted in parking lots at least 30 days apart. Usage rates from each survey must be 80% or greater to qualify for the Honor Roll. These are due by the end of the month for presentation by the Governor in the following month:

Survey #1

Date: Total # Observed: # Wearing Safety Belts: % Wearing Safety Belts: Name(s) of Observers:

Survey #2

Date: Total # Observed: # Wearing Safety Belts: % Wearing Safety Belts: Name(s) of Observers:

Please provide a brief summary of the data collection procedures used:

Safety Belt Information

Educational Plans for Safety Awareness

Safety Belt Check Date #1:
(One check will qualify you to be entered in the drawing for $500.)

Safety Belt Check Date #2:
(To qualify for the Honor Roll and the $1000 prize you must complete two checks 30 days apart. See attached letter for details)

School Crash History
(Has anyone in your community or school experienced a car crash that could teach to the importance of wearing safety belts?)

Total School Enrollment: