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This form is to help schools gather information for application to the International Safe Schools Designation Program of the World Health Organization Safe Community Network.  You may send in an e-mail, letter on letterhead, application report with supporting documents or fill out this form as a start and work with the International Safe Schools Office and its Affiliates to prepare your documents. You will be required to have a site visit, pay the applicable fee, and have all the final paperwork in prior to designation.

The on-line Application form is available.  This form is used for both pre-application and application.  In pre-application, a school considers each indicator from the perspective of where they are now and how they intend to improve and prove they fulfill the indicator.

In the application for designation the school demonstrates with data and analysis how it fulfills and will continue fulfilling each indicator, including a record of where it has been, where it is, and the next goals.

 Applicant School Name

(e.g. Joon Svanström)
(e.g. Headmistress)      

M







Telephone Country Code
FAX

School Type (Mark as many as apply):
   


With as much detail, supporting documents, photos, information, research, data and analysis as possible please describe how your school is achieving each of the Indicators below.  There are text fields for long descriptive answers and file upload buttons for your use.

Indicator 1: An infrastructure based on partnership and collaborations, governed by a group of teachers, pupils, technical staff and parents that is responsible for safety promotion in their school; the group should be chaired by a School Board (representative of school policy governance body) representative, with the Headmaster as a co-chair (hereinafter the Safe School Committee);

Indicator 2: Safe School policies decided by the Safe School Committee and Community Council in a Safe Community setting;

Indicator 3: Long-term, sustainable, operational school programs covering both genders and all ages, environments, and situations;

Indicator 4:  Programs that target high-risk groups and environments, and programs that promote safety for vulnerable groups;

Indicator 5:Programs that document the frequency and causes of injuries – both un-intentional (accidents) and intentional (violence and self-directed);

Indicator 6: Evaluation measures to assess school policies, programs, processes and the effects of change;

Indicator 7: Ongoing participation in Safe Schools networks – at community, national and international levels.

Thank you for filling out your application/ pre-application form.  After you click the submit button below, the International Safe Schools Program will review your documents and contact you with three days.  If you have not heard within that time, please send an e-mail to mlv@intlsafeschools.org to check to see that your application was received.

 

 

 

 

IMPORTANT CONTACTS

International Safe Schools
Max Vosskuhler
+1-520-990-5156

New Zealand Affiliate Centre- Safe Communities Foundation New Zealand
Tania Peters
+64 (9) 3608846

Korea Affiliate Centre
Ajou University Medical Centre for Injury Prevention
Prof. Joon Pil Cho

+82 (03) 1219-5286

WHO CC on Community Safety Promotion
Moa Sundström

+46 (08) 52480000

Charles University Centre for Injury Prevention - Czech Republic
Veronica Benesova
+420-2244-35943

Swedish Rescue Service Agency - Sweden
Annette Holmberg
+46 500 46 40 27

Centre for Child Injury Prevention - Hong Kong China
Prof. Chow, Chun-bong

+852-2990-3311

Ra'anana Safe Community - Israel
Sharon Goldman
+972-3-5303-9285

Cape Town South Africa Red Cross Children's Hospital
Prof. AB van As

Protectoras de la Vida - Brasil
Ms. Ananyr Porto Fajardo

Child Safety Promotion and Injury Prevention Research Center- Thailand
Prof. Ajarn Adisak Plitponkarnpim

Last updated: 16/11/05

Peaceful Resources Center - an Affiliate Safe Community Support Centre for the WHO Collaborating Centre on Community Safety Promotion © 2008 - 2001
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