Alive at 25



Alive at 25Registration FormClass Date: First Name:Social Security Number: Date of Birth: __________Current Mailing Address: City:Primary Phone Number: ________________________Email Address: _______________________Reason For Taking Course:________________Class Location: Last Name:Drivers License Number:Sex:MaleFemaleState:Zip:Referred by: (Complete only one [1] box)Name of County Court: County Judge:Name of County Attorney’s Office: County Attorney:Other Office: Name of Official:3270 Folkways Blvd., Ste. 201Lincoln, NE 68504-1264OFFICE 402.483.2511 \ FA X 402.483.2513nesc@Alive at 25Final TestName: of all occupant fatalities involving young drivers occur when the occupant is not wearing a safety belt.1/8 (one-eighth) 1/4 (one-fourth) 1/3 (one-third) 1/2 (one-half)What two questions should you ask yourself to help you choose safe and effective driving behaviors? Am I right? Is it fair?Will I get there? Will I be on time?Is anyone looking? Will I get in trouble?Is my behavior responsible? Is it respectful?What are the three steps in the DDC Collision Prevention Formula? Scan the road, proceed with caution, avoid collisionsRecognize the hazard, understand the defense, act correctly and in time React to the situation, avoid the collision, proceed with caution Remember the rules of the road, identify the dangers, avoid other vehiclesTrue or False: Survival, fun, freedom, power, and love and belonging are the five basic needs shared by all human beings.True FalseWhen driving, whose behavior can you control? My own behaviorMy own behavior and the behavior of my passengersMy own behavior and the behavior of the driver in the vehicle behind meMy own behavior, the behavior of my passengers, and the behavior of the driver in the vehicle behind meYou are the first vehicle at an intersection and the traffic light changes to green. What should you do?Proceed immediately and try to get through the intersection as quickly as possible Pull to the middle of the intersection and scan the roadWait 2 seconds and proceed only when its legal, clear and safeWait 5 seconds, inch forward to the stop line or cross walk and come to a complete stop, scan the road and proceed through the intersectionTo maintain a safe following distance and avoid following too closely, you should use the .Two-second rule Three-second ruleTechnique for passing safely Car length techniqueWhich of the following is associated with the use of a cell phone while driving? Manual distractionCognitive distraction Visual distractionAll of the above None of the aboveWhat three steps should you take to regain control and stop aggressive driving? Reflect. Reframe. Refocus.Start. Stop. Continue. Watch. Wave. Apologize. Act. Observe. Proceed.When scanning the road for potential hazards, what question can you ask yourself to keep alert and prevent a collision?What is responsible?What is the driving regulation? What if?What do I do?SubmitEvaluationAlive at 25Instructor Name: _________________________ Why did you take Alive at 25?Date of Course:_____________________Court / Probation Other___________________________________________________________________________________Have you taken Alive at 25 before?YesNoHow many hours did you spend in the entire Alive at 25 class you just completed? How would you rate the classroom?PoorFairGoodVery GoodExcellentHow would you rate the instructor?PoorFairGoodVery GoodExcellentHow would you rate the Student Course Guide? PoorFairGoodVery GoodExcellentHow would you rate the videos/multimedia?PoorFairGoodVery GoodExcellentDo you think Alive at 25 will help your Driving?Yes NoWhat two things did you learn in class? 1.)_________________________________________________________2.) _________________________________________________________Comments:Thank you for completing this evaluation3270 Folkways Blvd., Ste. 201Lincoln, NE 68504-1264OFFICE 402.483.2511 \ FA X 402.483.2513nesc@nesafetycouncil. ................
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