Make it Count!                                                                            

Participant Certificate Application

All Red Ribbon Programs Submit This Form

This year, we want to recognize EVERYONE who participates in the Georgia Red Ribbon Campaign. If your school, agency or business conducted Red Ribbon activities, large or small, please complete the short form below or fax it to 404-523-3649 by Dec. 1. We'll send you a Certificate of Appreciation, and we'll be able to count your efforts as we measure the reach of the Campaign.

Please provide the following contact information:

Name: (Individual or Group) Contact Person:
(as it is to appear on certificate)
Mailing Address: City: State:  Zip Code:
Phone Number: (include area code) Fax: Email:

Describe activity/ies

Describe outcomes

How many people planned the activities?

How many people did the campaign affect?

                                                                                                                                                                                                                                                                                                                                                                                                                    

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