Take the Distracted Driving Pledge & Enter a Raffle to Win a Prize

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Just Drive Pledge:

I pledge to Just Drive for my own safety and for others with whom I share the roads. I choose to not drive distracted in any way – I will not:

- Have a phone or text conversation – handheld, hands-free, or via Bluetooth
- Use voice-to-text features in my vehicle's dashboard system
-Use Facebook, Twitter, Instagram, Snapchat, TikTok, YouTube or other social media
-Check or send emails
-Take photos (including selfies) or film videos
-Input destinations into GPS (while the vehicle is in motion)
-Call or message someone else when I know they are driving

***By submitting this form you affirm that you Take the Distracted Driving Pledge to "Just Drive". ***

Email *

First Name, Last Name *

Stony Brook ID Number *

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

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Stony Brook University. Report Abuse

Forms