Join the Ban on PED Use while Driving

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* 1. Tell us about your nonprofit:

Nonprofit (or company) Name:

Number of Employees:

Number of Volunteers:

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* 2. Type your name if you agree to implement a total ban on PED use while driving by December 31, 2016, or begin the process of implementing a ban (such as by drafting a policy for review by your executive team or board).

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* 3. Provide your info if you want to receive updates about our PED ban campaign!

Name:

Title:

Email: