Educational Materials Order Form

Educational Materials Order Form

Please order in increments of 50. Requests from within the OKC metro area should be picked up at the Oklahoma Highway Safety Office; requests from other parts of the state may be picked up or shipped free of charge. Please mark your preference in the form below. You MUST designate a delivery method and date needed.

Basic Information
Name *

First Name Last Name
Email *
example@example.com
Agency/Organization *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Requested date of delivery/pickup *

Month Day Year
Date
How would you like to receive these items? *

Pick up in person Mail to my address
How will these items be distributed? *
Please explain if you chose "Other" above.

Child Restraint
Child Restraint
"Ride Right" Child Restraint (English)
"Ride Right" Child Restraint (Spanish)
Child Restraint (English)
Buckle Up Bookmark
Child Restraint Coloring Booklet
Contains four pages to color

Distracted Driving
Distracted Driving
Distracted Driving (English)

Impaired Driving
Impaired Driving
Drug-Impaired Driving (English)
Zero Tolerance (English)
Zero Tolerance (Spanish)
ENDUI (English)
Myths and Facts (English)
Myths and Facts (Spanish)

Motorcycle Safety
Motorcycle Safety
Motorcycle Safety (English)

Submit Request
**If requesting more than 500 pieces per item, please provide planned distribution information**
By signing below, the recipient agrees that they have had an "active voice" in the initiation, development and implementation of the program/project/literature, or that they request and accept the goods and services provided as a part of their local government's highway safety program. *

Clear
Name *

First Name Last Name
Should be Empty:

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