Buckle Up Phone Down: Accept the Challenge as a Business or Organization

Buckle Up Phone Down: Accept the Challenge as a Business or Organization
Does your company or organization meet the BUPD partner criteria?
- Do you require safety belt use in all company vehicles?
- Do you prohibit the handheld use of cellphones and other electronic devices?
Does your company or organization meet the criteria?*

YesNo
Company or Organization Name*
Industry
Name*

First NameLast Name
E-mail*
example@example.com
How many employees are a part of your company or organization?
Phone Number

Area CodePhone Number
How did you hear about Buckle Up Phone Down?*
Upload your company logo for our Partners webpage.

Upload a File
Images will be uploaded at 600px wide. .PNG format is preferred. Cancelof
Company Website Address:
Does your company or organization meet the Gold Standard?
- Do you require safety belt use in all company vehicles by policy?
- Do you ban ALL cellphone and electronic device use in company vehicles, even if it's hands-free?
If so, you meet the Gold Standard and we'll feature your logo on the front page of our site.

If not, we'll still feature your logo on our Partners page.

Thank you for your commitment to safety!
Does your company or organization meet the Buckle Up Phone Down Gold Standard?*

YesNo
Should be Empty: