Request a Safe Routes Event - Mississippi State Department of Health

Request a Safe Routes Event

Contact Information

Name
Position
E-mail address	E-mail is our primary means of contact; please provide an account that is frequently checked.

School Information

School Name
City
State
Principal
Office Phone

Performance Information

Safe Routes to School assemblies are tailored to the size of the audience. (Please be as accurate as possible; the materials provided are based on the number of participants given.)

Type of assembly requested
Total number of students attending
Type of assembly space	If Other, please specify: Gymnasium settings are preferred for Safe Routes events
Capacity of assembly space
Preferred date	and time
WIll you allow media coverage at this event?	Yes No

Thank you for requesting a Safe Routes to School assembly at your school designed to elementary and middle school aged children pedestrian and bicycle safety. The Mississippi State Department of Health's Safe Routes to School office will contact you within one week of receipt of your application to schedule a program.


		email this page		print this page

NEWSLETTERS