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School Safety Assessment Request Form - Alameda County Safe Routes to Schools
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* Indicates required question
School Name
*
Your answer
School Address
*
Your answer
Main School Contact Person's Name
*
Your answer
Main School Contact Person's Phone Number
*
Your answer
Main School Contact Person's Email Address
*
Your answer
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
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