2022 Drive for Change Pre-Seat belt Check Results Question Title * 1. Please Complete: Name of School or Youth Group: Date Seat Belt Check was Conducted: Survey Time (must be approximately the same time for pre and post check): Survey Location (must be the same location for pre and post check): Question Title * 2. Seat Belt Check Results:*Please ONLY give numerical data, no words or explanation. Total number of vehicles with all passengers belted during week 1 survey: How many vehicles were surveyed during the week 1 survey? Percent of people buckled up during the week 1 survey: Question Title * 3. SRO/ Sponsor Verifying the Results: Done