This program provides assistance to those individuals requesting child passenger safety car seats in the West Central Health District. 

Car Seat Education Class - After successful completion of the class, eligible individuals will receive a car seat for their child at no charge.  

Please complete the form and someone will contact you for one of our monthly Car Seat Education and Safety Classes.

Thank you.  

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* 1. What county do you live in?

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* 2. Please provide your full name.

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* 3. What is your phone number?

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* 4. What is your email address?

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* 5. Provide the age and approx. weight of the child that will be using the child car seat?  If you are currently expecting/pregnant, please advise.

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* 6. Financial Eligibility.  Please select one of the items listed below...

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