Your input regarding this course will greatly improve future planning and course improvements.

It will only take a few minutes to complete the survey. We greatly appreciate your time and input.

1. What grade are you in?

2. What school or military base did you attend the Street Smart presentation?

3. Gender

4. Race

5. Before you experienced a Street Smart presentation, did you always wear your seatbelt?

6. After experiencing the Street Smart presenation, will you start wearing your seatbelt always in any position in the vehicle?

7. After experiencing the Street Smart presentation, are you convinced that everyone in the vehicle needs to have a seatbelt on?

8. What are some of the reasons why you don't wear your seatbelt always?

9. Have you ever drank alcohol and driven a vehicle?

10. I find my driving to be distracting when I...

11. If a friend or family member was driving and was impaired, would you...

12. If you were in a situation where you have been drinking alcohol and needed to get home, would you....

13. Did you share your Street Smart presentation with any friends or family members?

14. If you answered yes to the above question, how many friends and family members did you share this with?

15. I would probably wear my seat belt more if I knew I would be stopped by the police for not using it.

16. How would you rate the Street Smart presentation.

17. The delivery of the Street Smart presentation was not condescending or demeaning.

18. Would you recommend this presentation to your peers?

19. Please tell us where you saw the presentation.

20. Please feel free to add any comments on your Street Smart experience. Also, please send us your email address if you have a Street Smart success story!