Webform The Southeast Coalition for Roadway Safety (SCRS) is one of seven regions of the Missouri Coalition for Roadway Safety. The Coalition is comprised of a diverse group of over 75 agencies located throughout south central and southeast Missouri, dedicated to saving lives and reducing serious injuries from traffic crashes. The Coalition meets in person quarterly (January, April, July & October). Due to the size of the district, meetings are held in Sikeston and Willow Springs (with the same content discussed at both meetings). Virtual option to attend is also provided. We invite you to join the Coalition as a partner, offering innovative solutions to lead us to zero fatalities on our roads. Membership in the Coalition is open to any person or organization (within the 25 counties of the MoDOT southeast district) that wishes to participate in developing and implementing strategies to reduce traffic crashes in the region. Members are required to attend a minimum of 2 meetings per year. If you cannot attend the minimum number of meetings, another representative from your organization may attend in your place. More information and a full description of duties can be found here. Please fill out the form below, to ensure the Executive Board has an understanding of your background and skills. Questions? Contact Ashley Metelski, ashley.metelski@modot.mo.gov * indicates required fields Name First Name* Last Name* Title* Contact Information Employer* Email* Phone* Address* City/Town State/Province - None -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 Traffic Safety Bio Please provide a brief bio explaining your background in traffic safety.* Briefly describe why you would like to join the Coalition. Briefly describe why you would like to join the Coalition.* What knowledge and/or skills will you bring to the Coalition? What knowledge and/or skills will you bring to the Coalition?* What would you like to personally gain from your membership in the Coalition? What would you like to personally gain from your membership in the Coalition?* Are you willing to assist with roadway safety presentations in the community? Are you willing to assist with roadway safety presentations in the community?* - Select -YesNo Reference Were you asked to become a member of the Coalition? If so, please list who suggested you join. Other Information Is there any other information about yourself that you would like to share with the Executive Board?* The Coalition has a Google My Map feature to showcase our Coalition partners across the state. Do you consent to have your organization's contact information showcased on www.savemolives.com/se? The Coalition has a Google My Map feature to showcase our Coalition partners across the state. Do you consent to have your organization's contact information listed on www.savemolives.com/se?* Yes, I Consent for My Agency's Contact Information To Be Placed On The Southeast Coalition for Roadway Safety's Website. No, I Do Not Consent for My Agency's Contact Information To Be Placed On The Southeast Coalition for Roadway Safety's Website. Supervisor's Contact Information Please list your supervisor's contact information.* Name* Title* Email Address* Phone Number* Meetings Yes, I will attend a minimum of two meetings per year. No, I Cannot Guarantee That I Can Attend A Minimum Of Two Meetings Per Year. Leave this field blank
