High School Representative Application-05.21.2019 \ / SAFE ROUTES to SCHOOL COORDINATOR
Cherie Walkowiak
10300 Torre Avenue •Cupertino, CA
�45.c.194,
Email: saferoutescupertino.orq
CUPERTINO
Cupertino Safe Routes to School (SR2S) High School Representative
Application for School Year 2019-20
Due Date: June 10, 2019
Email to: Saferoutes(a�cupertino.org
What is Safe Routes to School? Safe Routes to School(SRTS)is an international initiative targeted to
improve the health and well-being of youth by increasing the number of students who walk,bike,or
carpool to school. It is carried out through a process that combines education, encouragement events,and
infrastructure changes to remove barriers that get in the way of people traveling actively to and from
school. Cupertino Safe Routes to School(SR2S) is led by the City of Cupertino and focuses on all schools
within Cupertino and the students that attend them. The program is funded by the City of Cupertino and
operated in partnership with schools and school districts.
Why Students? Cupertino SR2S recognizes that once students move into high school they become the
real change-makers on their campuses. Students need NOT be a resident of Cupertino,they just need
to attend one of the 3 high schools inside Cupertino city limits(Monta Vista High, Cupertino High,
or Homestead High). Safe Routes to School believes that HS students know their schools and school
traffic patterns best and as such are the ideal candidates to join the SR2S program on behalf of their
student bodies. We need students to help us improve safety and accessibility for student pedestrians
and cyclists.
This Application: We are looking for students who are passionate about either bicycling,healthy
lifestyles, safe transportation,and/or campus safety to become a part of our Safe Routes to School
Working Group! This working group is composed of parents, school administrators, district
administrators, and students and meets once per month throughout the school year. Together this working
group co-creates the Cupertino Safe Routes to School program,coming up with education,
encouragement, and engineering elements to improve access for safe walking and biking for students.
By Being A Part of This Group You Will: Meet with us once a month and become a conduit of
information and ideas between your high school's student body and our City team. You will bring your
own ideas for improving safety, accessibility,and traffic reduction to the group and help implement those
ideas. You, along with other students,will be representing your school's needs for safer pathways to
school and working on an SR2S community project together.
Commitments-By becoming part of this group,you will commit to:
1) Attending every monthly meeting in the 2019-20 school year(10 total)to the best of your ability
2) Bring your ideas to the meetings and help implement them
3) Stay in active communication with the SR2S Coordinator and Parent Champions at your school
throughout the school year
4) Act as a liaison between your student body and our group of adult staff and volunteers
SAFE ROUTES to SCHOOL APPLICATION
CUPERTINO
SR2S Meeting Dates for SY 2019/20
*all meetings this year are 4-5 PM at Cupertino City Hall except August
• August 13, 2019 (4:30—5:30pm) • February 12, 2020 (4pm—5)
• September 17, 2019 (4pm—5) • March 11, 2020 (4pm—5)
• October 9, 2019 (4pm—5) • April 8, 2020 (4pm—5)
• November 13, 2019 (4pm—5) • May 13, 2020 (4pm—5)
• January 8, 2020 (4pm—5) • June 10, 2020 (4pm—5)
Full Name: Date:
(Last) (First) (Middle)
Address: Home Phone:
Cell Phone:
Email:
Education: What grade are you entering in Fall, 2019? 9❑ 10 11❑ 12❑
Name of High School:
**must be a student at Cupertino High School,Homestead High School, or Monta Vista High School**
In case of emergency please contact:
Name:
Relationship:
Daytime Phone:
Evening Phone:
SAFE ROUTES to SCHOOL APPLICATION
CUPERTINO
Statement of Commitment
I, , agree to attend and participate in Cupertino Safe Routes
to School Working Group meetings to the best of my ability. I understand that it is my duty to
relay information back to my school's study body and to actively work on projects in support
of Cupertino SR2S.
Signature Date
Signature of parent or guardian if under the age of 18 Date
To apply, email application to SafeRoutes@Cupertino.org, or mail to:
Cherie Walkowiak
c/o City of Cupertino
Safe Routes to School
10300 Torre Avenue
Cupertino, CA 95014
For more information about Cupertino SR2S, visit: www.cupertino.org/saferoutes.
For specific questions regarding this program or this application, email the SR2S team at
saferoutes@cupertino.org.
We hope you will apply!
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SAFE ROUTES to SCHOOL APPLICATION
CUPERTINO
Supplemental Questions
(Please answer the following questions using the space provided)
1. Why are you interested in the Safe Routes to School program?
2. What ideas or projects do you have in mind to help improve Cupertino Safe Routes to
School at the high school level? Be specific if possible.