steer clear program driverâ€™s - state farm

Steer Clear ®

Driver’sProgramSafety Awareness Program by State Farm®

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• TrytorememberthatIwasanewdriveroncetoo.

• Befairandreasonableinmyevaluationofyourdrivingprivileges.

• Trytobeabetterdriverandlistentoyourconstructivecomments.

• Bepatientandunderstanding.

• Givedrivingdirectionsclearly,calmlyandwellinadvanceofthemaneuver.

• CommunicatethefactthatIcareaboutyoursafetyinacalmandnon-emotionalway (especiallybehindthewheel).

• Listenandtrytounderstandyourpointofviewandconcerns.

• Positivelyrecognizeyouruseofgoodjudgment.

(Forparentsanddriversunderage19)

As a parent/guardian, I will:Parent/Driver Agreement

Other parent/guardian pledges:

• RememberthatIdon’thavealotofexperience,andIneedtolearn.

• Neverdriveundertheinfluenceofalcoholordrugs,orridewithadriverwhois.

• Notletanyoneelsedrivemycar,unlessitisanemergency.

• Takegoodcareofthecar.

• Alwayswearmyseatbeltandinsistthatpassengersdothesame.

• RecognizethatanyandalltrafficorparkingticketsIreceivearemyresponsibility.

• CallyouifI’mgoingtobelateorifmyplanschange.

• CallhomeforarideifIamevernotinaconditiontodrive(fatigued,emotionalorimpaired).

• PullovertoasafelocationifIhavetousemycellphoneforcalls,texting,orotherapplications.

• Limitdistractionsinmyvehicle.

As a newer driver, I will:

Other newer driver pledges:

Driver’sName:

ParentorGuardianName:

Date:

We both agree to the above behaviors, privileges and restrictions.

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• Iwillbeawareofwhat’sgoingonaroundme.

•Iwillneverdriveundertheinfluenceofdrugsoralcohol.

• Iwillalwayswearmyseatbeltandinsistmypassengersweartheirsinmycar.

• Iwillbecourteousandnotletmymoodaffectmydriving.

• IwillpullovertoasafelocationwhenIneedtousemycellphoneforcalls,texting,orotherapplications.

• IwillnotdriveifIamtootired.

• Iwillalwaysobeythedrivingrulesandtrafficlaws.

• Iwilllimitdistractionsinmyvehicle.

(Fordriversage19andolder)

PleasereadtheSafeDriverPledgeandsignitbeforeyoustarttheSteerClearprogram.

Safe Driver Pledge

Safe Driving Tips & Facts

Driver’sName:

Date:

Takeafewminutestoreadthroughthesetipsaboutsafedriving.Thoughyoumayhavehearditallbefore,whenitcomestosafetyandtakingproperprecautions,itneverhurtstoreviewthefacts.Becausesometimes,thefactsarescary,andhopefullythatalonewillremindyoutoalwaysdriveresponsibly.

Sources:1 Children’sHospitalofPhiladelpia(2007)Driving: Through the eyes of teens; A research report of the

Children’s Hospital of Philadelphia and State Farm Insurance.2NationalHighwayTrafficSafetyAdminstration(2006).TrafficSafetyFacts,2005Data:Speeding,DOTHS810629.3 NationalHighwayTrafficSafetyAdministration(2006).TrafficSafetyFacts,2005Data:Speeding,DOTHS810629.4 NationalHighwayTrafficSafetyAdministration(2006).NHTSA,VirginiaTechTransportationInstituteReleaseFindingsof

BreakthroughtResearchonRealWorldDriverBehavior,DistractionandCrashFactors,mediareleasedatedThursday,April20,2006.5McKnight,AJandMcKnight,AS(2003)Youngdrivers:carelessorclueless?InAccidentAnalysisandPrevention35(2003)921-925.

FACT:Almost2outof3teenskilledasoccupantsofmotorvehiclesareunrestrained.1Always Wear Your Seat Belt

Stay Within the Speed Limit and Adjust to Driving ConditionsFACT:In2005,38percentofthemaledrivers,ages15to20,whowereinvolvedinfatalcrashes, werespeedingatthetimeofthecrash.2

Know That Cars Can Crash Anywhere – Not Just on the Highway

Stay Focused on Driving – or Get Out of the Driver’s Seat

Whenever You Drive, You Should Scan the Road Constantly

FACT:In2005,86percentofallspeeding-relatedfatalcrashesoccurredon non-interstateroadsandhighways.3

FACT:Nearly80percentofcrashesand65percentofnear-crashesinvolvedsomeformofdriverinattentionwithinthreesecondsbeforetheevent.Driverinattentionincludesdistractingactivities,suchascellphoneuseanddrowsiness.4

FACT:About44percentofcrashesinvolvingyoungerandlessexperienceddriversinvolve afailuretocorrectlyscanahead,tothesideortherear.5

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Trip Log InstructionsTheTripLogisthemostimportantpartoftheSteerClearprogram,andcompletingitishowyougetyourSafeDriverDiscount.FollowtheTripLoginstructionscarefullysoyoucanreceivethediscountattheendoftheprogram.

1.TakethePre-LogDriver’sSelf-AssessmentatthebeginningoftheTripLogsection.

2. Drivers under age 19,complete20tripswith15supervisedbyalicenseddriveroverage25inthe next60days.Forthosewithalearner’spermit,all20tripsmustbesupervised.Tripsshouldbe 15to30minutesinlength.

ParentsoranadultdrivershouldcompletethePassengerAssessmentLogsaftertrips10and20.Drivers,besuretotakeatleasttwotripsasapassengerwithaparentoradultdriver.Observetheirdrivingandofferyourcommentsafteryou’vereachedyourdestination.

Drivers ages 19-24 or New Drivers,complete5tripsinthenext60days.Tripsshouldbeatleast 15minutesinlength.Bothdrivinggroupsshouldtakeavarietyoftrips,suchasonestowork, schoolorshopping.Also,considertakingtripsatvarioustimesandduringavarietyofweather andtrafficconditions.

Both driving groups should take a variety of trips, such as ones to work, school or shopping. Also, consider taking trips at various times and during a variety of weather and traffic conditions.

3.Foreachtrip,completethePre-TripLog (before you leave)andPost-TripLog(after you arrive).

4.Trips1-5and11-15haveDrivingReviewGoalspre-selectedforyou.Fortrips6-10and16-20,selecttheDrivingReviewGoalofyourchoicefromthelistintheTripLogsectionorcreateyourown.RecorditinthePre-TripLog.Asyoudrive,payattentiontothatparticularaspectofyourdriving.

How to Use This Trip Log:

Okayyou’vereadandreviewedeverythingyouneedtoknow,sonowyou’rereadytobegin—finally. KeeptheSteerClearKitinyourcarsoyoucangettotheTripLogeasilybeforeandaftereverytrip.Asyoucompletetrips,you’llbegintoseehowtheTripLogcanhelpyougaininsightintoyourowndrivingstyle.Plus,it’sahelpfultooltoreviewyourdrivingskills.

Trip Log

You’reabouttotakeyourfirsttrip,butbeforeyoudo,rateyourselfasadriver.Whatyoulearnmaysurpriseyou.On a scale of 1 to 5, how well does each statement describe you and your driving?

1 = Doesn’t describe my driving at all | 5 = Describes my driving perfectlyIalwayswearmyseatbeltandrequiremypassengerstoalso. 1 2 3 4 5Iamawareofwhat’sgoingonaroundme. 1 2 3 4 5Ilimitdistractionsinmyvehicle. 1 2 3 4 5Iusemyturnsignals. 1 2 3 4 5Iyieldtherightofway. 1 2 3 4 5Imaintainspeedlimitsoradjustspeedstosuitroadconditions. 1 2 3 4 5Iamacourteousdriver. 1 2 3 4 5Ineverdriveundertheinfluenceofdrugsoralcohol. 1 2 3 4 5IkeepmycoolwhileI’montheroad. 1 2 3 4 5Ianticipateproblemdrivers. 1 2 3 4 5Ineverallowmorepassengersthanthereareseatbeltsinmycar. 1 2 3 4 5Iplanaheadappropriatelytoallowfordelaysintraveling. 1 2 3 4 5I pullovertoasafelocationifIhavetousemycellphoneforcalls,texting,orotherapplications. 1 2 3 4 5

Pre-Log Driver’s Self Assessment Survey

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Now take a look at all your answers. Didyoucircle3orlessformostofyouranswers?Ifso,youshouldre-evaluateyourdrivingstyleasyougetreadytostarttheTripLogportionoftheprogram.

1.2.3.4.5.

1.2.3.

1 2 3 4 5NotVeryGood Fair Average Good Excellent

Take a Second to Write Down Some Things You Want to Work on:

Rate Yourself as a Driver :

Don’tforgettoselectaDrivingReviewGoalbeforeeachtrip.Or,youcancreateoneyourself.

1.Ilimitdistractionsinthevehiclewhiledriving(radio,passengers,food).

2.Iturnoffmycellphonewhiledriving.

3.Iproperlypreparefortripsbeforedriving(seat,mirrors,headrestraints).

4.Ialwayswearaseatbeltinthecarandmakesuremypassengersdotoo.

5.Iletaggressivedriverstaketherightofway.

6.Ifsomeonetailgatesme,Ichangelanesorpullofftothesideandletthempass.

7.Idon’t“punish”slowdriversbytailgating.

8.Inevertrytobeatayellowlight.

9.Iplantraveltimeaheadtomaintainthespeedlimitandarriveontime.

10.Atastopsign,Icometoacompletestopandthenlookleft,right,leftbeforeproceeding.

11.Idrivesloweratnight,inpoorvisibility,inresidentialareasandaroundschoolzones.

12.Ipracticegoodscanninghabits,soIcanidentifyandproperlyreacttooravoidrisksorproblems.

13.Iamawareofpedestriansandcyclistswhiledrivingandmakesuretogivethemplentyofroom.

14.Ialwayssignalbeforeturnsandlanechanges,evenwhennocarsarepresent.

Driving Review Goals:

Add Additional Driving Goals You Want to Work Toward Here:

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Date:

This trip is: Supervised Unsupervised(Drivers under age 19 only)

Driving goal: Iplantraveltimeaheadtomaintainthespeedlimitandarriveontime.

Going from:

Going to:

How long do you expect your trip to take?

Did the trip take the expected time? Yes No

What were the speed limits?

Did you exceed the speed limit? Yes No

What affected your travel time?

What would you do differently?

Post-Trip Log (complete this after you’ve returned from your trip)

Tip: Plan ahead appropriately to allow for delays in traveling.

Trip One Pre-Trip Log (complete this before you leave)

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Date:


Driving goal: Limitdistractionswhiledrivingandturnoffcellphones.

Are your cell phones or other personal electronic devices ON or OFF ?

Who are your intended passengers?

Did you use your cell phone while driving? Yes No

How many passengers did you have?

Did your passengers distract you? Yes No

If so, how?

Did you eat while driving? Yes No

What distractions did occur while you were driving?

What are ways to limit distractions?

Trip TwoPre-Trip Log (complete this before you leave)


Tip: Avoid distractions—radios and cell phones take your attention off the road.

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Date:


Driving goal: Properlyprepareyourvehiclefortripsandalwayswearaseatbelt.

Is everyone in the vehicle buckled up? Yes No

Does your head make full contact with the head restraint? Yes No

Did you adjust your rearview and side mirrors to minimize blind spots? Yes No

Why is it important that everyone in your vehicle wear a seat belt?

What other vehicle preparations could you have made before your trip?

Did you continually check your mirrors while driving? Yes No

Why is it important that you prepare your vehicle before each trip?


Tip: Buckle up—seat belts save lives.

Trip ThreePre-Trip Log (complete this before you leave)

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Date:


Driving goal: Practicegoodscanninghabitsandalwaysbeawareofhazards.

What type of hazards do you expect to see on your trip?

Before you put your vehicle in motion, have you scanned your surroundings? Yes No

What type of hazards did you detect during your trip?

How did you react to the hazards you detected?

How many posted speed limit signs did you see on your trip?


Trip FourPre-Trip Log (complete this before you leave)

Tip: Look well ahead of the cars in front of you to detect any changes or risks.

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Date:


Driving goal: Alwaysdrivedefensivelyandbeawareofaggressivedrivers.

How do you deal with an aggressive driver behind you?

Are you in a hurry? Yes No

What is your state of mind before your trip?

Anxious Relaxed Upset Neutral Other

How did your mood affect your driving?

Did you adjust your speed to accommodate the driving conditions (weather, light, residential area)?

Yes No

Did you encounter an aggressive driver during your trip? Yes No

If so, how did you handle the situation?

What distance did you maintain from the car in front of you?


Trip FivePre-Trip Log (complete this before you leave)

Tip: If you can, avoid driving in bad weather, congested traffic or after dark.

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HEY,ANDDRIVERS 19

OLDER

DRIVERS UNDER AGE 19, continueonpage12.

AfterTrip#5,you’redone withtheTripLogportionoftheprogram.

NowgototheCompleting the Programsectiononpage31totakethePost-LogDriver’sAssessmentsurvey.

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Date:


Driving goal: (choose a goal from page 5 or create your own)

Going from: to:



Did you achieve the driving goal(s) for this trip? Yes No

How did you manage the distractions in your vehicle?

Briefly summarize a lesson learned from this trip:

Other comments, thoughts or observations from this trip:


Trip SixPre-Trip Log (complete this before you leave)

Tip: No driving under the influence – this can impair your reaction time.

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Trip Seven

Tip: Pull over if you’re tired – fatigue slows reaction time.

Date:



Going from: to:








Pre-Trip Log (complete this before you leave)

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Trip Eight

Tip: Adopt a code word to allow you to ask for help from a parent or friend without embarrassment.

Date:



Going from: to:









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Trip Nine

Date:



Going from: to:









Tip: Drive safely: 58 out of 100 new drivers get into a crash in the first year.

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Tip: Drive smart: 16-year-olds are 20 times more likely than an adult to die in an automobile crash.

Trip Ten

Date:



Going from: to:









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Thedriveryou’reevaluatinghasjustcompletedTrip#10.Duringthosetrips,thedriverhaslikelyencounteredalotontheroad.That’swhynow’sagoodtimetoreviewthedriver’sprogress.Sometimesoon,letthedriverusethislogtoevaluateyourdrivingtoo.

Reviewing passenger name:

Date:

Relationship to driver: Parent/Child Friend Other

Did the driver ask you to put on a seat belt? Yes No

Did the driver limit distractions? Yes No

How does the driver deal with aggressive drivers? Yields Fights Ignores

Was the driver always aware of his/her speed? Yes No

Did the driver stay within the speed limit? Yes No

Did the driver use signals when turning and changing lanes? Yes No

Two words that describe the person’s driving style?

&

Did you feel safe riding with the driver? Yes No

How can this driver become an even safer driver?

Other comments:

Passenger Assessment Log #1 (For parents or driving supervisors of drivers under age 19)

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Tip: Think driving fast is cool? Think again. Speed kills, and since when is being dead cool?

Date:


Driving goal: Iplantraveltimeaheadtomaintainthespeedlimitandarriveontime.

Going from:

Going to:

How long do you expect your trip to take?

Did the trip take the expected time? Yes No

What were the speed limits?

Did you exceed the speed limit? Yes No

What affected your travel time?

What would you do differently?


Trip Eleven Pre-Trip Log (complete this before you leave)

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Date:


Driving goal: Limitdistractionswhiledrivingandturnoffcellphones.


Who are your intended passengers?

Did you use your cell phone while driving? Yes No

How many passengers did you have?

Did your passengers distract you? Yes No

If so, how?

Did you eat while driving? Yes No

What distractions did occur while you were driving?

What are ways to limit distractions?

Trip TwelvePre-Trip Log (complete this before you leave)


Tip: Know your passengers and always keep them under control while driving.

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Tip: Be sure all passengers, front and back seat, are buckled up before you start to drive.

Date:


Driving goal: Properlyprepareyourvehiclefortripsandalwayswearaseatbelt.


Does your head make full contact with the head restraint? Yes No

Did you adjust your rearview and side mirrors to minimize blind spots? Yes No

Why is it important that everyone in your vehicle wear a seat belt?

What other vehicle preparations could you have made before your trip?

Did you continually check your mirrors while driving? Yes No

Why is it important that you prepare your vehicle before each trip?


Trip ThirteenPre-Trip Log (complete this before you leave)

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Tip: Maintain a safety zone around your vehicle at all times.

Date:


Driving goal: Practicegoodscanninghabitsandalwaysbeawareofhazards.

What type of hazards do you expect to see on your trip?

Before you put your vehicle in motion, have you scanned your surroundings? Yes No

What type of hazards did you detect during your trip?

How did you react to the hazards you detected?

How many posted speed limit signs did you see on your trip?


Trip FourteenPre-Trip Log (complete this before you leave)

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Tip: Limit nighttime driving – most serious teen crashes occur at night.

Date:


Driving goal: Alwaysdrivedefensivelyandbeawareofaggressivedrivers.

How do you deal with an aggressive driver behind you?

Are you in a hurry? Yes No

What is your state of mind before your trip?

Anxious Relaxed Upset Neutral Other

How did your mood affect your driving?

Did you adjust your speed to accommodate the driving conditions (weather, light, residential area)?

Yes No

Did you encounter an aggressive driver during your trip? Yes No

If so, how did you handle the situation?

What distance did you maintain from the car in front of you?


Trip FifteenPre-Trip Log (complete this before you leave)

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Date:



Going from: to:








Trip SixteenPre-Trip Log (complete this before you leave)

Tip: Adopt a parent/teen contract that defines expectations and consequences.

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Tip: Always scan for potential hazards and important roadside cues and information that can help you stay safe.

Trip Seventeen

Date:



Going from: to:









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Tip: Ensure you are familiar with the vehicle’s controls before driving.

Trip Eighteen

Date:



Going from: to:









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Tip: Take a moment before you start your trip to adjust your side and rearview mirrors to the correct position.

Trip Nineteen

Date:



Going from: to:









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Tip: One of the biggest hazards at intersections is making left turns. It takes proper positioning, patience and planning.

Trip Twenty

Date:



Going from: to:









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Yoursupporthaslikelybeenabighelptothedriver.Plus,yourownsafedrivingskillshavesetagoodexampleforthedrivertofollownowandinthefuture.Assessthemonelasttimeandremindthemtorememberthelessonsthey’velearnedthroughouttheprogram.

Reviewing passenger name:

Date:

Relationship to driver: Parent/Child Friend Other

Did the driver ask you to put on a seat belt? Yes No

Did the driver limit distractions? Yes No

How does the driver deal with aggressive drivers? Yields Fights Ignores

Was the driver always aware of his/her speed? Yes No

Did the driver stay within the speed limit? Yes No

Did the driver use signals when turning and changing lanes? Yes No

Two words that describe the person’s driving style?

&

Did you feel safe riding with the driver? Yes No

How can this driver become an even safer driver?

Other comments:

Passenger Assessment Log #2 (For parents or driving supervisors of drivers under age 19)

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HEY,

UNDER AGE 19!DRIVERS

You’redonewiththeTripLogportionoftheprogram.NowgototheCompleting the Programsectiononpage30

totakethePost-LogDriver’sSelf-Assessmentsurvey.

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Bynowyou’veencounteredallkindsofdrivers,weatherandtrafficconditions,andotherobstaclesontheroad.Areyoubetterpreparedforwhat’stocomethenexttimeyou’reontheroad?FindoutbytakingthePost-LogSelf-Assessmentsurvey.On a scale of 1 to 5, how well does each statement describe you and your driving?

1 = Doesn’t describe my driving at all | 5 = Describes my driving perfectly

Ialwayswearmyseatbeltandrequiremypassengerstoalso. 1 2 3 4 5

Iamawareofwhat’sgoingonaroundme. 1 2 3 4 5

Ilimitdistractionsinmyvehicle. 1 2 3 4 5

Iusemyturnsignals. 1 2 3 4 5

Iyieldtherightofway. 1 2 3 4 5

Imaintainspeedlimitsoradjustspeedstosuitroadconditions. 1 2 3 4 5

Iamacourteousdriver. 1 2 3 4 5

Ineverdriveundertheinfluenceofdrugsoralcohol. 1 2 3 4 5

IkeepmycoolwhileI’montheroad. 1 2 3 4 5

Ianticipateproblemdrivers. 1 2 3 4 5

Ineverallowmorepassengersthanthereareseatbeltsinmycar. 1 2 3 4 5

Iplanaheadappropriatelytoallowfordelaysintraveling. 1 2 3 4 5

You’vedonealotofhardwork,andyou’realmostfinished.But,there’sonelastthingyouneedtodo…takethePostLog-Driver’sSelf-Assessmentsurvey.

Post-Log Driver’s Self-Assessment Survey

In which areas did you see the most improvement?

Completing the Program

MakesureyoucompareyourPre-LoganswerstoyourPost-Loganswers.Didyourresponseschange?Whathaveyoulearnedaboutyourselfandyourdrivingabilities?Youcanwriteyourcommentsinthespacesbelow.Driversunderage19,askyourparentoradultdrivertogivetheirfeedbacktoo.

1.

2.

3.

1 2 3 4 5NotVeryGood Fair Average Good Excellent

Rate Yourself as a Driver:

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What areas do you still need to work on?

Notes:

1.

2.

3.

CONGRATULATIONS!You’realldone.Okay,nowwhaddya’do?YoushouldvisityourStateFarmagent.Youragentwilltalktoyouabouttheprogram

andreviewyourTripLog.Plus,ifeverythinglooksgood, you’llgettheSteerClearSafeDriverDiscount.

Thanks for participating in the Steer Clear Driver’s Program!

Policyholder’sName

QualifyingDriver(‘s)Name(s)

PolicyNumber

Steer Clear Discount Initial Requirements1.Qualifyingdriver(s)havemaintainedanaccident-freeandmovingviolation-freedrivingrecord

inthepastthreeyears,*

2.Qualifyingdriver(s)havecompletedtheeducationalanddrivinglogrequirementsingoodfaith,and

3.AllprivatepassengerautomobilesinthehouseholdareinsuredwithStateFarmAutomobileInsuranceCompany,StateFarmFireandCasualtyCompany,StateFarmIndemnityCompany,StateFarmGuarantyCompany.**

To Maintain Steer Clear Discount1.Qualifyingdriver(s)continuetomaintainanaccident-freeandmovingviolation-freedrivingrecord.*

2.Qualifyingdriver(s)shouldcompleteSecondEducationmaterialreceivedpriorto21stbirthday.

Applicant’s StatementIhavemettheinitialrequirementsfortheSteerClearsafedriverdiscountandunderstandthatIwilllosethediscountifIaminvolvedinanat-faultaccidentorreceiveamovingviolation.ThediscountwillalsoberemovedwhenIam25yearsoldorsoonerifIamclassifiedasanadultpriortothatage.

SignatureofQualifyingDriver Date



Date

Statement for Qualification for Steer Clear ® Discount

*In some states, certain accidents and moving violations may not disqualify you. **In some states, this requirement does not apply. 1002295 135394.7 08-27-2009

AgentNameandCode

SignatureofParent/Guardian/NamedInsured(ifqualifyingdriverisunderage18)

State Farm Mutual Automobile Insurance Company State Farm Fire and Casualty Company State Farm Indemnity Company State Farm Guaranty Insurance Company

steer clear program driverâ€™s - state farm

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