Petition for Safer Streets & Traffic Calming Measures

Gather verified resident signatures and safety concerns to present a compelling traffic calming petition to your local city council and transportation department.

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Neighborhood Traffic Calming & Pedestrian Safety Measures Community Petition Form

Full Name

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Email Address

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Phone Number

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Submit

The Neighborhood Traffic Calming & Pedestrian Safety Measures Community Petition Form empowers residents to take collective action against dangerous road conditions in their community. It captures petitioner contact details, specific street and intersection concerns, observed traffic hazards, and preferred calming solutions—giving local authorities the comprehensive data they need to act.

This template is ideal for neighborhood associations, community groups, HOAs, and concerned residents who want to formally request speed humps, crosswalks, signage, or other infrastructure improvements. Each submission is verified with residential address and tenure information, lending credibility and legitimacy to the petition when presented to city councils or departments of transportation.

With built-in fields for incident descriptions, urgency ratings, and public hearing attendance willingness, this form transforms individual safety concerns into a unified, actionable community voice. Start collecting signatures online today and build a persuasive case for safer streets—no coding required.

3 Pages

18 Questions

~6min To complete

Free No credit card needed

Field types Single Choice ×3 Short Text ×2 Multiple Choice ×2 Long Text ×2 Full Name Email Phone Address number Priority Selection richtext termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Petitioner Information 6 questions

Petitioner Information

Please provide your contact details to validate your signature on this community petition. Your information will be kept confidential and used solely for petition verification purposes.

1 Full Name * Full Name

2 Email Address * Email

3 Phone Number Phone

4 Residential Address * Address

5 Neighborhood / Subdivision Name * Short Text

6 How many years have you lived at this address? * number

Page 2 Traffic & Pedestrian Safety Concerns 6 questions

Identify Your Traffic & Pedestrian Safety Concerns

Help us understand the specific issues affecting your neighborhood so we can present a comprehensive petition to local authorities.

1 Street(s) or Intersection(s) of Primary Concern * Short Text

2 What traffic and safety issues have you observed? (Select all that apply) * Multiple Choice

3 Which traffic calming measures do you support? (Select all that apply) * Multiple Choice

4 How urgent is the need for traffic calming in your area? * Priority Selection

5 Have you or someone in your household witnessed or been involved in a traffic-related incident on these streets? * Single Choice

6 Please describe the specific safety concerns or incidents you have experienced or witnessed Long Text

Page 3 Petition Statement & Signature 6 questions

Petition Declaration & Signature

1 **We, the undersigned residents, hereby petition the [City/Town] Council and Department of Transportation to conduct a comprehensive traffic safety study of our neighborhood and implement appropriate traffic calming and pedestrian safety measures. We believe that current conditions pose an unacceptable risk to pedestrians, cyclists, children, and all community members. We respectfully request prompt action to reduce vehicle speeds, improve pedestrian infrastructure, and enhance the overall safety of our streets.** richtext

2 Would you be willing to attend a public hearing or community meeting regarding this petition? * Single Choice

3 May we include your name on the public petition presented to local officials? * Single Choice

4 Additional comments or suggestions for improving traffic safety in our neighborhood Long Text

5 I confirm that I am a resident of the affected neighborhood and that the information I have provided is accurate. I understand that my signature will be counted toward the community petition for traffic calming and pedestrian safety measures. * termsandconditions

6 Petitioner Signature * Signature

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.