2020 Transportation Safety Leadership Training
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Email *
First Name *
Last Name *
Organization
Job title
Street address *
City *
Zip code *
Phone Number *
Gender *
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What language(s) do you speak? *
Check the training events you wish to apply for. By checking an event you are confirming your commitment to attend all applicable dates. *
Required
Do you commit to report on all outreach activities and events and provide follow-up information and evaluations to NVRC? * *
Who is your mentor? Include Mentor name, title, affiliation, email, and phone number. Select someone who can help you connect with safety outreach events and verify your outreach requirements are completed after training. * *
Do you need assistance identifying a mentor?
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Does your mentor commit that you will complete the requested training and activities * *
Why do you want to receive this training? *
Why do you think this training will be useful to you? *
How comfortable are you riding a bike for an extended period of time on roads? *
When was the last time you rode your bike for at least 30 minutes in city traffic. * *
When was the last time you rode your bike for at least 30 minutes on a mixed use path or trail? *
Approximately how often do you walk or hike? (If interested in Pedestrian Safety Training)
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What distance do you typically walk or hike? (If interested in Pedestrian Safety Training)
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What is your comfort level walking or hiking? (If interested in Pedestrian Safety Training)
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A copy of your responses will be emailed to the address you provided.
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