Congress Heights Safe Passage Interest Form

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Please fill this form out to sign up and learn more about supporting Safe Passage in the Congress Heights area for student safety!

Email *

Be A Safe Passage Leader in Congress Heights!

First Name *

Last Name *

Days and Times of Availability

Please mark the number of days you are available to support Congress Heights Area Safe Passage Efforts

Mondays 3-5pm

Tuesdays 3-5pm

Wednesday 3-5pm

Thursdays 3-5pm

Fridays 3-5pm

Please contact me about morning opportunities

I am available 5 days a week from 3-5pm

Row 1

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Locations of Priority you Prefer

First Preference

Second Preference

Third Preference

Fourth Preference

Fifth Preference

W4 Bus Stop @ Randle and Alabama Ave.

W1 Bus Stop @ Randle and Alabama Ave.

W1 Bus Stop on on 4th St. (south bound)

W1 Bus Stop on 4th St. (north bound)

3100 Block of Martin Luther King Ave

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What do We need to know about YOU as we work together? *

How can we best contact you for training and orientation? *

What days are you available for training? *

Any Day between 3-5pm

Wednesdays between 2-5pm

Mornings from 9-10am

Other:

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