Screen Reader Mode Icon

Sponsored by Safe Kids Columbus; led by Piedmont Columbus Regional Midtown

Welcome to the Application Process for the Safe Kids Columbus Virtual Car Seat Class held on ZOOM, that includes a low-cost Car Seat ($20) for eligible parents/caregivers. This educational program is taught by currently Certified Child Passenger Technicians. The focus of this program is on education and teaching you how to keep your baby safe.

Question Title

* 1. This course requires pre and post surveys and a non-refundable $20 donation to Safe Kids Columbus.

Question Title

* 2. How did you hear about the Safe Kids Car Seat Class?

Question Title

* 3. I understand that foster parents and non-custodial grandparents or relatives are not eligible for this program.

Question Title

* 4. I am CURRENTLY enrolled in Medicaid (Example: Amerigroup, CareSource, Peach State, Unknown)
Be prepared to show your enrollment card at the start of the online class.

Question Title

* 5. I am CURRENTLY enrolled in WIC

Question Title

* 6. I am CURRENTLY enrolled in another financially screened program not listed for low-income individuals/families or have another potentially eligible circumstance I wish to share.

Question Title

* 7. I am NOT currently in a financially screened program but I am in need of low cost car seat assistance because ...

Question Title

* 8. Are you or your parent partner a member of any branch of the military?

Question Title

* 9. I understand that if I do not qualify for the Safe Kids equipment, I am eligible to attend the class for educational purposes only.

Question Title

* 10. I understand that I must attend a 2-hour interactive car seat class in order to receive a low-cost new convertible car seat.

Question Title

* 11. The following class guidelines must be followed. If you are not following these guidelines, you will be dropped from the class and rescheduled.
1. If accepted: Make a $20 non-refundable donation to Safe Kids Columbus.
2. You must remain in one location during the entire class.
3. You cannot drive or be a passenger in a vehicle during class.
4. You are required to keep your camera on and be on screen at all times.
5. Proper attire for a classroom setting required
6. No talking/texting during class unless speaking with the instructor.

Question Title

* 12. Contact Information: You must live in the following counties to participate - GA: Muscogee; AL: Lee, Russell

Question Title

* 13. Child's Demographics
You will need to apply separately for each child

Question Title

* 14. Does your child have any special healthcare needs?

Question Title

* 15. From the list below, please select the best option for your situation

Question Title

* 16. Have you received a free or low-cost car seat from Safe Kids Columbus in the past in 12 months?

Next Steps:
  • Applicants accepted into our program will receive an email confirmation with class date and time.
  • If accepted, make your non-refundable $20 donation to www.safekidscolumbusga.org
  • Monthly classes are held at 4pm online using ZOOM
  • Drive-thru car seat pick-up date/time will be provided during your class.
0 of 16 answered