Arrive Alive Registration & Order Form for High Schools
Please submit this form by 5:00p.m. on March 3, 2017 to ensure you receive campaign materials on time.
Our school will take part in the 2017 Arrive Alive Campaign by...
Name of High School
Your answer
School Address
Please include city or town, state, and zip code
Your answer
School Telephone Number
Your answer
Current Student Enrollment
Your answer
Number of Students in your club
Your answer
School Resource Officer/ Sponsor
This should be the individual assisting students with the campaign
Your answer
Your answer
Email Address
Your answer
Campaign Materials
How many Survive the Drive Tip Cards would you like?
How many Prom/Floral Arrive Alive Cards would you like?
How many "What to do After a Crash" cards would you like?
How many Arrive Alive Pledge Banners would you like?
How many "Don't be a Party Crasher" posters would you like?
How many Text Later Live Longer Stickers would you like?
How many Sunglasses with a Safety Message would you like? (These were provided by the Allstate Foundation)
Campaign Sponsor Agreement
I agree to abide by the rules of the Arrive Alive campaign and to adhere to all deadlines.
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