Gift of Safety Application 2019-2020
Please complete and submit by 8pm EST, on April 1, 2019.
Email address *
About Buckle Up for Life (BUFL):
Our Vision:
To be the leader in eliminating motor vehicle related injuries and deaths among children.

Our Mission:
Buckle Up for Life will provide child passenger safety education and life-saving resources to families everywhere.

Learn More:
www.buckleupforlife.org
www.facebook.com/buckleupforlife

About BUFL's Gift of Safety Initiative
The Gift:
Each program year (July 1st - June 30th) BUFL will provide 3,750 car seats to families in need across the United States, through the Gift of Safety initiative. Each of 50 selected agencies will be awarded 75 car seats (50 Evenflo Titan 65 convertibles and 25 Evenflo Amp no back boosters) free of charge (shipping and handling included) to distribute along with child passenger safety education to families in their local communities.

Learn More:
http://buckleupforlife.org

Agency Eligibility:
Nonprofit organizations, as determined under section 501(c)(3) or 509(a) of the Internal Revenue Code, and public service agencies (e.g., fire/police departments, local health departments, public schools, etc.) are eligible to apply.

Agencies must have access to at least one certified Child Passenger Safety Technician (CPST). This individual must be available to provide education and assistance to each family receiving a car seat to ensure that it is installed and used correctly.

Agencies must serve at-risk populations, and be able to identify need in their own communities.

Expectations:
Car seats may be distributed at the agency's discretion--although the focus should be on at-risk populations. Each agency may assess and determine local need.

Car seats and education must be provided by a certified Child Passenger Safety Technician (CPST) who can ensure that seats are installed and used correctly.

Each recipient of a car seat must complete and sign a Car Seat Pact, which BUFL will provide. This brief survey will provide some basic demographic data on the program's participants. Although Car Seat Pacts do not need to be returned to BUFL, each agency is expected to provide a roll up report of these findings to BUFL on a quarterly basis (see Deliverables, below). Click below to view a sample Car Seat Pact:
https://drive.google.com/file/d/0B-qoDlcJkSXnbTRPLXBjODF1YUk/view?usp=sharing

Car seats provided by Buckle Up for Life must be given away to selected families for FREE. Seats may not be sold.

All car seats must be given away by June 30, 2020.

Deliverables:
Selected agencies must participate in a required one-hour Welcome Webinar, sign a BUFL Curriculum and Brand Usage Agreement, and provide minimal reporting to BUFL on a quarterly basis (see Next Steps).

Each agency must distribute 75 car seats, for free, to local families in need, by June 30, 2020.

Each agency must provide child passenger safety education with each car seat distributed.

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