Program School Order Form and Online Access Request

The 2020-2021 school year will look very different for all of us, but rest assured that Teens in the Driver Seat is ready to continue being your go-to as the teen traffic safety messaging and outreach source. Car crashes are still the leading cause of injury and death for teens in America and fighting that is still our mission. A focus on social-distancing activities, large messaging, and online resources will keep your team engaged each month as we deliver new content and ideas ready to use.

Learn more about the steps to starting a team.

If you are one of the following schools, simply complete the form below to become an active Teens in the Driver Seat school and receive access to online resources, a physical resource kit, program support and a chance to earn incentives for your team:

Arizona High Schools
California High Schools
Colorado High Schools
Delaware High Schools
Georgia High Schools and Middle Schools
Indiana High Schools
Kentucky High Schools
Michigan High Schools

Missouri High Schools
Nebraska High School and Middle Schools
New York High Schools
Ohio High Schools
Oklahoma High Schools
Tennessee High Schools
Texas High Schools and Middle Schools

We are adding states quickly! If you are not in the above listed program areas, complete this information to gain access to all online resources and online monthly traffic safety ideas delivered to your inbox and we will let you know if your state is added to our program area. If you would like to learn how to get Teens in the Driver Seat in your area, learn more about our Partnering Opportunities>

Sign up to be a Program (select areas) or Virtual School or Organization (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 online monthly traffic safety ideas delivered to your inbox along with links for downloading. You may unsubscribe at any time.

INFORMATION FOR SCHOOLS:

At this time, Teens in the Driver Seat cannot support outreach and activities completed at your school or in your community, however, 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

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?

Online Access

Complete this information to gain access to all online resources and online monthly traffic safety ideas delivered to your inbox along with links for downloading. You may unsubscribe at any time.

INFORMATION FOR SCHOOLS:

At this time, Teens in the Driver Seat 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

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?

Arizona High School Sign-Up

School Information

School Name - please use full school name

Who can we thank for referring you?

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

Work Phone

Cell Phone

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

I opt out of the monthly newsletter

School Shipping Information

Address Line 1

Address Line 2

City

Postal Code

Resource Kit Order Details

School Student Population

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

This year, we have a limited number of fence cup sets. These are put-in-place cups that lock into a chain link fence. They will be sent in a bundles of green, white, and black along with instructions and recommended messages. To see the messaging, please visit http://www.t-driver.com/wp-content/uploads/2020/09/fence-cups.pdf . Messaging requires up to 32 feet of chain link fencing. Cups are weather resistant and reusable. Messaging using fence cups can be reported for All-Star points.

Yes, please send my team a set of fence cups.

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

We understand school schedules may be uncertain, so if your school is not open or you are not on campus at this time, please let us know how to handle your kit. We can hold it or send it to an alternate address, as long as someone will be there.

California High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

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

This year, we have a limited number of fence cup sets. These are put-in-place cups that lock into a chain link fence. They will be sent in a bundles of green, white, and black along with instructions and recommended messages. To see the messaging, please visit http://www.t-driver.com/wp-content/uploads/2020/09/fence-cups.pdf . Messaging requires up to 32 feet of chain link fencing. Cups are weather resistant and reusable. Massaging using fence cups can be reported for All-Star points. Please select YES below to receive a set of fence cups.

Yes, please send my team a set of fence cups.

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Colorado High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

Small (25-749 students)Large (750+ students)

Do you need Spanish materials?

Yes

Yes, please send my team a set of fence cups.

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Delaware High School Sign-Up

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

Work Phone

Cell Phone

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

I opt out of monthly emails

School Shipping Information

Address Line 1

Address Line 2

City

Postal Code

Resource Kit Order Details

School Student Population

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

Yes, please send my team a set of fence cups.

Team t-shirts

Each school may order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Edit this text

Oklahoma High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

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

Do you need Spanish materials?

Yes

Yes, please send my team a set of fence cups.

Team t-shirts

SMALL School - up to 6 shirts

MEDIUM School - up to 8 shirts

LARGE School - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Georgia High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

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

Yes, please send my team a set of fence cups.

Team t-shirts

Order up to 12 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Georgia Middle School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

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

Indiana High School Sign-Up

In order to receive the kit and resources, we need your commitment to conduct surveys in your school, as follows. High Schools with a student population of:

449 students or less complete a minimum of 150 surveys or half of the population
450-1059 students complete a minimum of 200 surveys
1060+ students complete a minimum of 250 surveys

We also ask you complete activities and messaging of all sizes on a regular basis! When you do these activities, let us know what you did by completing an activity form.

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

Do you agree to complete program requirements (surveys and observations) and let us know of activities/messaging conducted?

Yes

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.

Resource Kit Order Details

School Student Population

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

Yes, please send my team a fence cup set.

Team t-shirts

Order up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Kentucky High School Sign-Up

School Information

School Name - please use full school name

Who can we thank for referring you (Name or School or Organization or Media Outlet)

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

Work Phone

Cell Phone

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

I opt out of the monthly newsletter

School Shipping Information

Address Line 1

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

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Yes, please send my team a fence cup set.

Michigan High School Sign-Up

In order to receive the kit and resources, we need your commitment to conduct surveys in your school, as follows. High Schools with a student population of:

449 students or less complete a minimum of 150 surveys or half of the population
450-1059 students complete a minimum of 200 surveys
1060+ students complete a minimum of 250 surveys

We also ask you complete activities and messaging of all sizes on a regular basis! When you do these activities, let us know what you did by completing an activity form.

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

Do you agree to complete program requirements (surveys and observations) and let us know of activities/messaging conducted?

Yes

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.

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

Yes, please send my team a fence cup set.

Missouri High School Sign-Up

In order to receive the kit and resources, we need your commitment to conduct surveys in your school, as follows. High Schools with a student population of:

449 students or less complete a minimum of 150 surveys or half of the population
450-1059 students complete a minimum of 200 surveys
1060+ students complete a minimum of 250 surveys

We also ask you complete activities and messaging of all sizes on a regular basis! When you do these activities, let us know what you did by completing an activity form.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

Do you agree to complete program requirements (surveys and observations) and let us know of activities/messaging conducted?

Yes

School Shipping Information

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)

Yes, please send my team a fence cup set.

Team t-shirts

Order up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

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 [email protected] or call 402-471-0361.

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

Small (1-275 students)Medium (276-1000 students)Large (1001+ students)

Yes, please send my team a fence cup set.

Team t-shirts

SMALL schools - up to 6 shirts

MEDIUM schools - up to 8 shirts

LARGE schools - 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 [email protected] or call 402-471-0361.

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

Small (1-275 students)Medium (276-1000 students)Large (1001+ students)

Team t-shirts

SMALL schools - up to 6 shirts

MEDIUM schools - up to 8 shirts

LARGE schools - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

New York School Sign-Up

School Information

School Name - please use full school name

Who can we thank for referring you?

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

Work Phone

Cell Phone

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

I opt out of the monthly newsletter

School Shipping Information

Address Line 1

Address Line 2

City

Postal Code

Resource Kit Order Details

School Student Population

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

Yes, please send my team a fence cup set.

Team t-shirts

Order up to 10 shirts.

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Ohio High School Sign-Up

In order to receive the kit and resources, we need your commitment to conduct surveys in your school, as follows. High Schools with a student population of:

449 students or less complete a minimum of 150 surveys or half of the population
450-1059 students complete a minimum of 200 surveys
1060+ students complete a minimum of 250 surveys

We also ask you complete activities and messaging of all sizes on a regular basis! When you do these activities, let us know what you did by completing an activity form.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

Do you agree to complete program requirements (surveys and observations) and let us know of activities/messaging conducted?

Yes

School Shipping Information

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

Order up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Yes, please send my team a fence cup set.

Tennessee High School Sign-Up

In order to receive the kit and resources, we need your commitment to conduct surveys in your school, as follows. High Schools with a student population of:

449 students or less complete a minimum of 150 surveys or half of the population
450-1059 students complete a minimum of 200 surveys
1060+ students complete a minimum of 250 surveys

We also ask you complete activities and messaging of all sizes on a regular basis! When you do these activities, let us know what you did by completing an activity form.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

Do you agree to complete program requirements (surveys and observations) and let us know of activities/messaging conducted?

Yes

School Shipping Information

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)

Yes, please send my team a fence cup set.

Team t-shirts

Order up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Texas High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

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

Do you need Spanish materials?

Yes

Yes, please send my team a fence cup set.

Team t-shirts

SMALL school - up to 6 shirts

MEDIUM school - up to 8 shirts

LARGE school - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

Texas Junior High School Sign-Up

Previous Program School Lookup

School Name Lookup

New School Information - Complete if your school information is not found in the lookup above.

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

Work Phone

Cell Phone

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

I opt out of monthly emails.

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.

Resource Kit Order Details

School Student Population

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

Team t-shirts

SMALL school - up to 6 shirts

MEDIUM school - up to 8 shirts

LARGE school - up to 10 shirts

Small

Medium

Large

X-Large

XX-Large

Total Requested

Date Needed

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

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

Online Access

Online Access

Arizona High School Sign-Up

California High School Sign-Up

Colorado High School Sign-Up

Delaware High School Sign-Up

Oklahoma High School Sign-Up

Georgia High School Sign-Up

Georgia Middle School Sign-Up

Indiana High School Sign-Up

Kentucky High School Sign-Up

Michigan High School Sign-Up

Missouri High School Sign-Up

Nebraska High School Sign-Up

Nebraska Middle School Sign-Up

New York School Sign-Up

Ohio High School Sign-Up

Tennessee High School Sign-Up

Texas High School Sign-Up

Texas Junior High School Sign-Up

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