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Love Your Self, BTB Seatbelt Survey

Presented by: C.A.R.E.S ClubTN

Our mission is to establish and assist teen-managed advocacy programs in high schools throughout the Mid-South that focuses on traffic safety education, unsafe driving practices and emphasizes on preventive ways to decrease crashes, injuries, and fatalities amongst teen drivers.
1.Full Name
2.Age(Required.)
3.Gender(Required.)
4.Email
5.School/Organization
6.Zip Code(Required.)
7.What is your race or ethnicity?(Required.)
8.How often do you drive a motor vehicle(Required.)
9.When DRIVING a vehicle, how often do you wear your seat belt?)(Required.)
10.As a PASSENGER, how often do you wear your seat belt?(Required.)
11.Which one of the following encourages you to wear your seatbelt (click all that apply)?(Required.)
12.Did you know that Tennessee has a law requiring the wearing of seat belts by drivers and passengers?(Required.)
13.How likely is it that you will wear your seatbelt after learning about seatbelt awareness through the C.A.R.E.S Program?(Required.)
Very Likely
Likely
Somewhat Likely
Not Likely