Road Safety Presentation Interest Form

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The Nebraska Safety Council offers a free one-hour road safety presentation that is developed to keep your employees safe on the road. The presentation covers: Drugs, Exhaustion, Alcohol, and Distracted Driving. Sign up today!

*This is funded by the Nebraska Department of Highway Transportation.

Email *

First Name:

Last Name:

Company:

County:

Phone Number:

Preferred contact method:

Phone Call

Are you a member of the Nebraska Safety Council?

Yes

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Does your organization have a current cell phone policy?

Yes

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Does your organization have a current seat belt policy?

Yes

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How did you hear about the road safety presentation?

Website

Other:

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A copy of your responses will be emailed to the address you provided.

Submit

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