Webform The Southeast Coalition for Roadway Safety is one of seven regions of the Missouri Coalition for Roadway Safety. The coalition is comprised of a diverse group of individuals and agencies located throughout south central and southeast Missouri, dedicated to saving lives and reducing serious injuries from traffic crashes. We focus on education, community outreach and partnerships, enforcement and leadership that advances Missouri’s Strategic Highway Safety Plan. The Southeast Coalition for Roadway Safety’s Executive Board has approved the purchase of car seats to promote the importance of child passenger safety and occupant protection. Health departments, hospitals, and other organizations with Certified Child Passenger Safety Technicians in south central and southeast Missouri are eligible to apply. The coalition will provide both convertibles and high back boosters through this grant. Your organization must guarantee that the car seats will not be distributed without the parent/guardian being educated on the installation of child passenger safety seats by a CPS Technician. Car seat distribution guidelines: must be a Missouri resident and go to a low-income family. Additionally, we will follow up with organizations receiving the child safety seats to find out how many have been distributed throughout the year. An assessment will be sent out in May. This is a requirement of the grant and information collected will be shared with our Executive Board. While we cannot guarantee the purchase of all requested quantities, we do hope to help as much as possible. Agencies must have participated in a minimum of four coalition meetings in the previous 24 months to be considered for a grant. Granted seats to a non-participating organization may be considered, but only after participating agencies have been prioritized. Please provide below your projected quantity needs for the next 6 months. This grant process is open December 1-31. Questions? Contact Ashley Metelski, ashley.metelski@modot.mo.gov *- indicates required fields Contact Information Contact Information* Name Agency/Organization Name Email Phone Physical Address City/Town State/Province - Select -AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificBritish ColumbiaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNewfoundland and LabradorNew Brunswick New HampshireNew JerseyNew MexicoNew YorkNorthwest Territories North CarolinaNorth DakotaNorthern Mariana IslandsNova Scotia NunavutOhioOklahomaOntarioOregonPalauPennsylvaniaPrince Edward Island Puerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon ZIP/Postal Code How many convertible car seats has your agency given out from January 1- November 30? How many convertible car seats has your agency given out from January 1- November 30?* How many high back booster car seats has your agency given out from January 1- November 30? How many high back booster car seats has your agency given out from January 1- November 30?* How many convertible car seats does your agency currently have in stock? How many convertible car seats does your agency currently have in stock? How many high back booster car seats does your agency currently have in stock? How many high back booster car seats does your agency currently have in stock? Has your agency received car seats from MoDOT's Highway Safety and Traffic Office in the last 12 months? Note: this is different from what you're applying for right now. Has your agency received car seats from MoDOT's Highway Safety and Traffic Office in the last 12 months? Note: this is different from what you're applying for right now. Yes No Number of convertible car seats requested. Number of convertible car seats requested.* Number of high back booster seats requested. Number of high back booster seats requested.* List all current Child Passenger Safety Technicians at your agency.* List all current Child Passenger Safety Technicians at your agency.* List any campaigns, car seat check events, programs, community/school events, presentations or any other outreach efforts you have participated in (in the last year) to promote roadway safety in your area.* List any campaigns, car seat check events, programs, community/school events, presentations or any other outreach efforts you have participated in (in the last year) to promote roadway safety in your area.* Guarantee Yes, I can guarantee that my organization will only allow granted car seats to be properly "installed" by a CPS Technician. I also agree that car seats will only be distributed to low-income Missouri families. "Installed" meaning the CPST would teach the parent/guardian how to properly adjust the harness, teach them how to install the seat in their vehicle, provide information as to which location in the car may be best for the seat, uninstall the seat and then have the parent install it. This takes away the liability of the CPST, as the parents should be the ones to put the product in before they drive away. No, I cannot guarantee that my organization will distribute car seats without being properly "installed" by a CPS Technician. I also cannot guarantee that car seats will only be distributed to low-income Missouri families. Once you click 'Submit', your Grant Application will be sent to the SCRS Representative. The Executive Board will be reviewing all grant applications at the beginning of January. The SCRS Representative will let you know the Executive Board's decision then. 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