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Thank you for your interest in the road safety advocates programme!

If you would like to get involved, please complete the participation form below and we will be in touch, either by phone or email, to explore future opportunities.

Thank you for submitting your road safety advocates participation form. We will be in touch, either by phone or email, within the coming weeks to discuss future opportunities.

Road Safety Advocates Programme

Participation form

 

First name *

Last name *

Email address *

Contact number *

Location

Were you, or a loved one, involved in a road collision previously?

Yes

No

Has this collision featured in the media?

Yes

No

I'm not sure

Are there legal proceedings ongoing?

Yes

No

Background story

Which of the following areas would you be interested in?

Please tick

RSA website feature

Social media content

Attendance at RSA events

Blog post feature

Press release quotation

Audio press release

Video production

Photographs

Television interviews

Radio interviews

National or local print interviews

RSA Advertisements

Data protection *

I consent to being contacted by the RSA in relation to my enquiry and agree that my details may be stored securely for this purpose.

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