Thank you for helping us make the areas around schools safer. Please only consider the immediate area of the main school gate/entrance (considered to be 200 yards). Although not absolutely necessary, please undertake the assessment during school drop-off and pick-up times of the day. The 'School Crossing Patrol' only applies if you are assessing during these times - it is not mandatory.

* 1. Name of school

* 2. Name of road (main gate)

* 3. City/town

* 4. Type of school e.g. primary (if known)

* 5. Date of assessment

* 6. Time of assessment

* 7. What is the speed limit of the road outside the main gate?

* 8. How many of the following crossings are present?

* 9. Are there speed bumps present?

* 10. Are there railings present outside or near the main gate?

* 11. As far as you can tell, is the main gate used for cars as well as children?

* 12. Does the school have a dedicated car park for parents (not teachers)?

* 13. Does the school have a dedicated cycle lane?

* 14. What is the quality of the pavement like? (1 being outstanding; 4 being inadequate)

* 15. What is the quality of the 'SCHOOL' and zig-zag road markings like? (1 being outstanding; 4 being inadequate)

* 16. Is there different coloured tarmac (red/green) present? Please identify colour and location

* 17. Notes: Here, please tell us of any obstacles or other road layout issues within 200 yards of the school entrance which could be deemed as dangerous to a child arriving or leaving the school

Once again, many thanks for helping us make the areas around schools even safer for children.

Kind regards
The AXA RoadSafe Schools campaign team

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