School Safety Assessment Mini-Grant Application

Request for Information

First Name
Last Name
Agency / District
Mailing Address
  *required field
Work Phone
Cell Phone
Email Address
  *required field
Fax Number
Time frame for completing assessment
  (number of days)
Number of physical schools to be assessed:
Number of physical buildings:
Date of last assessment (if known):
Are you required to utilize a bidding process to make decision?
  Yes No
Would you like current crisis plans, Evacuation plans also reviewed?
  Yes No
Version 1.0


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