2022 Arrive Alive Pre-Seat belt Check Results Question Title * 1. Please Complete: Name of School or Youth Group: Date Seat Belt Check was Conducted: Survey Time (must be approximately the same time for pre and post check): Survey Location (must be the same location for pre and post check): Question Title * 2. Seat Belt Check Results:*Please ONLY give numerical data, no words or explanation. How many vehicles were checked during the pre- campaign survey? Total number of vehicles with ALL passengers belted during the pre- campaign survey: Percent of people buckled up during the pre- campaign survey: Question Title * 3. Adult Sponsor Verifying the Results: Done