Sign up to be a Program (select areas) or Virtual User (all areas)

Let's get started! Tell us where you are and what type of organization you are with.

Your Country

Outside US

Your State

Inside US

Your organization type:

High SchoolMiddle SchoolOrganizationOtherIf you are a student or staff member of a program school and only want virtual access, please select other.

Online Access

Complete this information to gain access to all online resources and traffic safety ideas delivered to your inbox. You may unsubscribe at any time.

INFORMATION FOR SCHOOLS:

At this time, Teens in the Driver Seat staff cannot support outreach and activities completed at your school or in your community. If funding becomes available to support your school, we will notify you. By providing the below information, you will have access to online resources and materials to help with your existing traffic safety outreach efforts. Thank you for your work in traffic safety and keeping our drive alive!

Please watch your email (including spam) for a welcome message with login information within 48 hours Monday - Friday.

First Name

Last Name

Email

Your City

School or Organization Name - please use full name; no acronyms.

Which of the below describes your position at your organization?

StudentTeacher / School Staff
Other

What is the estimated number of people you plan to reach?

We often have community resource kits available to safety partners. If you qualify and kits are available, would you like one?

Yes!No, thanks.

Shipping Information

Shipping Address Line 1

Shipping Address Line 2

City

State

Postal Code

Online Access

Complete this information to gain access to all online resources and traffic safety ideas delivered to your inbox. You may unsubscribe at any time.

INFORMATION FOR SCHOOLS:

At this time, Teens in the Driver Seat staff cannot support outreach and messaging activities completed at your school or in your community; however, by providing the below information, you will have access to online resources and materials to help with your existing traffic safety outreach efforts.Thank you for your work in traffic safety and keeping our drive alive!

Please watch your email (including spam) for a welcome message with login information within 48 hours Monday - Friday.

First Name

Last Name

Email

Your Country

School or Organization Name - please use full name; no acronyms.

Which of the below describes your position at your organization?

StudentTeacher / School Staff
Other

What is the estimated number of people you plan to reach with this information?

School Sign-Up (GM funded)

School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student organization or group name conducting program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

Address Line 1

Address Line 2

City

ST

Postal Code

Resource Kit Order Details

School Student Population

Small (25-449 students)Medium (450-1059 students)Large (1060+ students)

Team t-shirts

Order up to 12 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Would you like to receive Spanish resources?

Yes

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Date needed.

Colorado High School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

Order up to 12 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Would you like to receive Spanish resources?

Yes

Date Needed

Oklahoma High School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

SMALL & MEDIUM Schools - up to 8 shirts

LARGE Schools - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Would you like to receive Spanish resources?

Yes

Date Needed

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Georgia High School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student organization or group name conducting program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

Order up to 12 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Would you like to receive Spanish resources?

Yes

Date Needed

Georgia Middle School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student organization or group name conducting program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-399 students)Medium (400-749 students)Large (750+ students)

Team t-shirts

Order up to 12 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Louisiana School Sign-Up

School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

SMALL & MEDIUM Schools - up to 8 shirts

LARGE Schools - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Would you like to receive Spanish resources?

Yes

Date Needed:

Nebraska High School Sign-Up

If you are interested in starting Teens in the Driver program in your Nebraska High School, please complete the form below. It will be directed to Jeanne Bietz, who will be in contact. If you have questions, please contact Jeanne Bietz at Jeanne.Bietz@nebraska.gov or call 402-471-0361.

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Nebraska Middle School Sign-Up

If you are interested in starting Teens in the Driver program in your Nebraska Middle School, please complete the form below. It will be directed to Jeanne Bietz, who will be in contact. If you have questions, please contact Jeanne Bietz at Jeanne.Bietz@nebraska.gov or call 402-471-0361.

New School Information

School Name - please use full school name

Who can we thank for referring you? (Name or school or organization)

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Texas High School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

If an address was found, but you updated it, please tell us why.

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

SMALL & MEDIUM schools - up to 8 shirts

LARGE schools - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Do you need Spanish materials?

Yes

Date Needed

Texas Junior High School Sign-Up

New School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student Organization or Group Conducting Program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

The address we have on record (if a previous program) is shown here. Please update here, if no address found or out-of-date.

Shipping Address Line 1

Shipping Address Line 2

City

Postal Code

If an address was found, but you updated it, please tell us why.

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-399 students)Medium (400-749 students)Large (750+ students)

Team t-shirts

SMALL & MEDIUM schools - up to 8 shirts

LARGE schools - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Wyoming High School Sign-Up

School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student organization or group name conducting program.

How many teens will be working on this project?

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

Shipping Address Line 1

Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Resource Kit Order Details

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Washington High School Sign-Up

School Information

School Name - please use full school name

Who/what prompted you to sign up?

Student organization or group name conducting program.

How many teens will be working on this project?

School Student Population

Small (25-449 students)
Medium (450-1059 students)
Large (1060+ students)

Teacher/Sponsor Contact Information - this will be the primary contact.

First Name

Last Name

Email

Work Phone

Cell Phone

If you do not want to receive activity ideas and information, please let us know by checking this box.

I opt out.

School Shipping Information

Address Line 1

Address Line 2

City

Postal Code

Social Media - please complete if you would like us to tag your team or school on posts regarding your activities or students.

Facebook handle:

Twitter handle:

Instagram handle:

TikTok handle:

Do you need Spanish materials?

Yes, please send Spanish materials.

Date needed.