* 1. Please Complete:

* 2. Describe in detail your Creative Project ONLY. Include the traffic safety topic your project addressed, how you used the Arrive Alive theme and artwork, how club members/students were involved in developing and implementing the project, when the project took place, how many students participated in or saw/heard the project, how the project was creative, what donated resources were used (including any donations by the school), any results you measured or observed through surveys, pledges, etc., and any other information to make your project clear to the judging panel. The Creative Project will be judged on content, student involvement, and creativity - so please detail this information as much as possible.

* 3. Please provide a numbered list of Call To Action Activities your club completed for this campaign aside from the Creative Project.  (Remember to include basic activities such as making announcements, displaying posters, etc, and also include how you used the campaign banner.)

* 4. Did you have a BikeSafe presentation with the Mid-Atlantic Foundation for Safety and Education? If so, briefly describe the presentation and how many students were present.

* 5. Briefly describe how the campaign materials were used (tip cards, pencils, posters, banner).  If you made or used other materials, briefly describe the item(s) and how many of each were distributed.

* 6. Give an estimated number of tip cards and pencils distributed. (Please ONLY enter numerical data, no words.)

* 7. Student Leadership:

Give an estimated total number of club members/students who led or planned the Arrive Alive campaign activities and Creative Project. (Please ONLY enter numerical data, no words.)

* 8. Student Participation:

Give an estimated to total number of STUDENTS who actively PARTICIPATED in an activity and/or attended an educational program or event (includes students who stopped by a display table for information, attended a presentation, signed a pledge, drove through the distraction checks, etc.) Please ONLY enter numerical data, no words.

* 9. Students Reached:

Give an estimated total number of STUDENTS who heard or saw the campaign message through school announcements, social media, banners, poster displays, educational activities, etc. aside from the Creative Project, etc. (Please ONLY enter numerical data, no words.)

* 10. Community/Public Reached: 

Give an estimated total number of those who saw the campaign message through media coverage generated by your school's campaign efforts. (Please ONLY enter numerical data, no words.)

* 11. Creative Project:

* 12. Overall rating: Please rate the peer-to-peer Arrive Alive campaign provided by the YOVASO staff based on its quality, creativity, ease of implementation, and engagement of the teen audience.

* 13. Survey Wrap Up: