Search
Search
Get Started
Menu
Home
Students and Sponsors
Educational Activities
Enforcement
Resources
History
Contact Us
SAFE Program Agreement Form
Sponsor Contact Information
Name Of School:
(Required)
County Name:
(Required)
SAFE Sponsor Name:
(Required)
School/Agency Name:
(Required)
Phone
(Required)
Email
(Required)
Shipping Information
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Additional Contacts
Contact #1 Name:
Contact #1 School/Agency Name:
Contact #1 Phone:
Contact #1 Email:
Contact #2 Name:
Contact #2 School/Agency Name:
Contact #2 Phone:
Contact #2 Email:
Additional Information
School Color(s):
(Required)
Official School Mascot:
(Required)
Upload your school mascot logo (optional)
Accepted file types: pdf, jpg, png, Max. file size: 20 MB.
Participating Building Student Body Population:
(Required)
Number Of Students On SAFE Team:
(Required)
Do You Need Safety Vests?
Yes
No
Do You Need Pledge Cards?
Yes
No
How Many Pledge Cards Do You Have Remaining?
If an existing club adopted the SAFE program, please list their name (example: StuCo, NHS, FFA, FCCLA, KAY, FBLA, FCA):
Please indicate what grades (middle and/or high school) will be part of the SAFE program in this building: