YES - I would like to help fight youth addiction to tobacco by presenting the Tar Wars Program at a local school.
Please fill out the following completely.
Name
Title
Address
City
Zip
Contact Information:
Phone
Other
E-Mail
What is your prefered method of contact?
Phone
Other
E-Mail
Do you have a school preference? Please list in order of preference.
Would you be willing to travel to surrounding areas?
Would you be willing to participate in Tar Wars in the upcoming years?
Yes - I will continue to participate in Tar Wars until I notify
Maybe - Contact me next year
Yes
No
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