Join the Partnership
The 20 questions below help us take an inventory of your school's current activities while learning about you.

Thank you for all that you do to improve safety for students in Iowa!

Email *
Email *
Name *
School
School District *
SRTS contact (A contact can be a student, teacher, parent/grandparent, school official, or anyone else who would like to be the point of contact with the Iowa SRTS Leadership Committee for this school) *
Have you held at least one of the following walk/bike education or encouragement events in the past school year? (Check all that apply)
Have you put one safety tip on the school website or in the school handbook?
Clear selection
Have you publicized your school's commitment to SRTS on the school's website?
For example, posting safe walking/rolling maps to school or posting a statement supporting students using active transportation for their school commute.
Clear selection
Have you collected student travel information in the past school year? (Iowa SRTS programs typically collect this information through an online survey)
Clear selection
Does your school have a SRTS Champion? (The Champion can be a parent volunteer, staff, student, or community member involved in organizing SRTS activities at your school.) If yes, please provide the name and email for that person.
During the past school year, has your school provided monthly active travel information through school e-news, newsletter, or backpack mail?
Clear selection
In the past school year, has your school held at least one walk/bike/skate education activity?
In the past school year, has your school held at least one walk/bike/skate encouragement event?
In the past two school years, did your school provide multi-day walking or biking education?
Clear selection
Has your school held a walk audit/assessment within the last 10 years?
Clear selection
Does your school hold ongoing active travel programs at least monthly?
Clear selection
In the past school year, has your school provided multi-day walking or biking education?
Clear selection
Has your school developed a School Action Plan and posted it on the website?
Clear selection
Has your school mapped safe routes and posted them on the school website?
Clear selection
Has your school adopted a supportive policy (a formal statement of support for walking, biking, and skating to/from school), promoted it to parents, and posted it on the school website?
Clear selection
Does your school provide annual in-class bicycle and pedestrian education?
Clear selection
Does your school include a SRTS position in the PTA/PTO/parent organization?
Clear selection
Does your school have a student or parent safety club/committee?
Clear selection
Has your school hosted a student-led event or activity in the past school year (such as Walk+Roll to School Day, students presenting the SRTS policy to the school board or city council, etc.)?
Clear selection
Does your school designate an annual budget for SRTS activities?
Clear selection
(EDIT) Do you have any feedback, questions, comments, or concerns about Iowa SRTS School
Thank you
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Iowa Bicycle Coalition.