Safety Smart Presentation Report LifeSmarts wants to hear about your Safety Smart Ambassador experience. Complete this form (one form per team, per presentation) and your team will be entered into a monthly drawing for prizes. Safety Smart Presentations Submit this form every time you complete a Safety Smart presentation. Step 1 of 3 33% PresentersStudent 1 NameStudent 2 NameCoach's NameCoach's Email address Enter Email Confirm Email Coach's PhoneSchool/OrganizationSchool/Organization Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PresentationDate of Presentation MM DD YYYY Title of PresentationSetting for presentationSchoolClub/Organization/OtherPlease describeNumber of children participatingGrades of children participating Pre-K Kindergarten 1st grade 2nd grade 3rd grade 4th grade 5th grade Other Check all that applyPlease describe Presentation DetailsHow did you adapt the lesson for your particular situation?How did your audience respond to the information you provided in the lesson? Give examples.What did your team learn from the Safety Smart experience?Document your presentation by uploading photos and other files. Drop files here or Accepted file types: jpg, gif, png, pdf, ppt. EmailThis field is for validation purposes and should be left unchanged.