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* 1.
Please Complete:

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* 2. Please provide a numbered list of activities and programs your club completed during week one (Kickoff Week) of the campaign to announce the Drive for Change campaign at your school. Remember even simple activities count including making announcements, displaying posters, banners, etc.

Your numbered list should look like this example:
1. Created our own Buckle Up posters and displayed them around the school.
2. All club members posted a speed prevention message on their Instagram account.
3. Announced the campaign kickoff during the morning announcements.

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* 3. Please provide a numbered list of activities and programs your club completed during week two (Spirit Week) of the campaign to promote slowing down and buckling up. Remember even simple activities count including making announcements, displaying posters, banners, etc.

Your numbered list should look like this example:
1. Created a buckle up cheer with the cheerleading squad to perform at pep rally.
2. Plastered the hallways with signage (in our school colors) about slowing down.
3. Students dressed in our school colors to show their commitment to buckling up. 

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* 4. Please provide a numbered list of activities and programs your club completed during week three (Take Action Week) of the campaign to demonstrate how students have changed their driving behaviors as a result of the campaign. 

Your numbered list should look like the examples in question 2 and 3.

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* 5. Please provide a numbered list of activities and programs your club completed during week four (Halloween Week) of the campaign to promote making good choices and celebrating safely over Halloween weekend.

Your numbered list should look like the examples in question 2 and 3.

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* 6. Did your school or youth group order campaign materials from YOVASO or download the digital files from the website?

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* 7. Briefly describe how the campaign materials were used and give an estimated number of bookmarks and buckle up reminder cards distributed. If you made or used other materials, briefly describe the item and how many of each were distributed.

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* 8. Student Leadership:

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* 9. Student Participation:

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* 10. Total Reach: 

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* 11. Overall Rating:
Please rate the peer-to-peer Drive for Change campaign provided by the YOVASO Staff based on its quality, creativity, ease of implementation, and engagement of the teen audience.

*Please note you are rating the campaign, materials, and resources provided by YOVASO, not your club's participation.

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* 12. Survey Wrap Up:

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