Operation TEACH Material Request and Activity Summary

We have information and free materials you need to implement Operation TEACH activities. Simply copy and fill out this form, and fax it back to Operation TEACH at (202) 366-6916. Or you can visit NHTSA's web site at: www.nhtsa.dot.gov When your activities are complete, you could be recognized for your efforts. Use this form to outline your program and results to be eligible for recognition.

Name: Grade Level:

Organization/school :

Address:

City: State : ZIP:

Phone Number: Fax Number :

E-mail address :

Brief description of activities:

Please send me materials available to implement Operation TEACH in my school, organization or community.

We have completed Operation TEACH and want to be considered for recognition. Below is a brief description of our program and the results we have achieved. Please attach additional description or materials if necessary.

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