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Iowa Safe Routes Partnership
posted by
nick
on
Tue, 11/15/2011 - 11:50
School Name
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School Address
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City, Zip Code
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Telephone Number
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Email Address
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Website
Fax Number
School Hours
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When do classes begin in the morning and dismiss in the afternoon,
Start/end date of current school year
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Principals Name
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Principals Email Address
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Principals Phone Number
Champion 1 Name
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School champions serve as a coordinator for programs and as a contact person
Organization/role
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Is your champion a parent volunteer, school faculty, community member, etc.
Champion 1 Email
*
Champion 1 Telephone
Champion 2 Name
*
Org/role
*
Champion 2 Email
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Champion 2 Telephone
I commit to helping my school grow its Safe Routes to School Program in all aspects
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yes
Do you Currently have a Safe Routes to School Program?
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yes
no
If yes, when did it begin?
What are the main programs or activities of SRTS that exist or you would like to see exist at your school?
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How many students attend this school? List total students per grade:
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What percentage of students live within one mile of school?
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How many students qualify for regular bussing?
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Approximately how many students walk or bicycle to school on a regular day?
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What are the current general conditions around your school?
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Sidewalks or paths exist for students choosing to walk or bicycle to school.
The roads around the school are heavily traveled by motor vehicles.
There are traffic signals or crosswalks around the school.
A school travel plan exists and is available to students and parents.
Our schools has ___ crossing guards assigned to the school.
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Any additional comments regarding conditions around the school
The following stakeholders will participate or currently participate in our SRTS Program:
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Principal or Assistant Principal
School Faculty or Staff
Local Law Enforcement
Parents/PTA/PTO
Local Government Officials
Additional Comments or Questions:
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