General Information :
*School/organization:
Report Prepared By:
We presented to/did
_an activity for:

Type of Activity:

Alchol-Free-Fun
Awareness Campaign
Education
Advocacy

Grade level/age group
presented to:

The number of people
we reached with our
event/activity:
Please give a brief
description of event/
activity/presentation:
The number of people
we reached with our
event/activity:
Media/Publicity included:
This activity/presentation
promoted an alcohol-free
message because:
*Phone:
*E-mail:
Fax:
 

* Denotes Required Field