School Safety Assessment Request Form
Alameda County Safe Routes to Schools Program
Name of School
Address of School
Name of Requesting Person
Please Check All that Apply to Your School
We have a Safe Routes to Schools leader (parent or staff) at our school
Parents have a strong concern about traffic safety
Parents have strong concerns about crime or other safety issues
We have a program to encourage walking and/or bicycling to school
Thank you for your commitment to providing safer, more walkable neighborhoods for children and families!
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