Project Prevent Chapter Activity Report Question Title * 1. School or Organization Name OK Question Title * 2. Chapter Name OK Question Title * 3. Sponsor's Name First Last OK Question Title * 4. Phone Number OK Question Title * 5. Email Address OK Question Title * 6. Shipping Address (No PO Boxes) Street Address Address Line 2 City State/Province/Region Zip/Postal Code County OK Question Title * 7. Date of Activity Date / Time Date OK Question Title * 8. Title of Activity OK Question Title * 9. Activity Topic OK Question Title * 10. Activity Description OK Question Title * 11. Did media cover the event? Yes No OK Question Title * 12. # of Project Prevent Chapter Members who participated in the activity OK SUBMIT