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School Enrollment Form
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* Indicates required question
School Name
*
Your answer
City
*
Your answer
School District
*
Your answer
Who should we contact to get started? Please list name and role at school. If you, please list your information
*
Your answer
Phone
Your answer
Email
*
Your answer
What are your goals for participating in the Alameda County SR2S Program?
*
Your answer
Does your school have an existing Safe Routes to Schools or Safety Champion (i.e., a designated school site coordinator for the program; could be either a parent volunteer or school staff)?
*
Yes, parent volunteer
Yes, school staff
No
Don't know
Did you obtain approval from the school principal to start a Safe Routes to Schools program at your school?
*
I'm the principal
Yes
No (Don't worry! We can still help get you started. We can contact the principal directly.)
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