Alameda County Safe Routes to Schools — Drive Your Bike Request Form
The Alameda County Safe Routes to Schools Program is funded by the Alameda County Transportation Commission (www.alamedactc.org). Your transportation dollars at work!

Thanks for your interest in the Alameda County Safe Routes to Schools' Drive Your Bike program.

Drive Your Bike is an in-class bicycle safety training course for middle and high schools that emphasizes improving bike handling skills, educates students about the rules of the road and exposes students to safe biking routes to their schools. The middle school program is a 5-day in-class program, while the high school program is four days. Drive Your Bike can be scheduled Monday-Friday from September 2017 through June 2018.

Please fill out the form below to request a Drive Your Bike P. E. class at your school.

School Name *
Your answer
School Address *
Your answer
School District *
Your answer
School Principal's Name *
Your answer
School Principal's Main Contact Information
Please provide the best phone number or email address for your school's principal (if known).
Your answer
Main School Contact's Name *
Please provide the name of the person who will help us schedule and coordinate this event at your school.
Your answer
Main School Contact's Phone Number *
Your answer
Main School Contact's Email Address *
Your answer
What is the best way to communicate with the main school contact? *
Please provide at least three potential start dates for your school's Drive Your Bike P. E. program. *
Your answer
Is there anything we should know about your bell schedule? *
i.e. short days on Wednesdays, block scheduling, etc.
Your answer
Number of students in your largest class. *
Your answer
Number of students interested in participating and their grade level(s). *
Your answer
Is there a place at your school to store bikes during the program? *
Please describe. Note that we prefer an indoor space to store the bikes.
Your answer
Please check the boxes next to the requirements to indicate that your school can provide them. *
Required
Does your school provide bike racks for student and staff use? *
Is your school enrolled in the Alameda County Safe Routes to School Program? *
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