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Regional Prevention Partnerships
Alcohol and Other Drug Use Prevention:  Collaborating with Law Enforcement Partners

Please tell us more about yourself.

This information will help us fulfill our grant requirements and let us know who we are serving or not serving in our community. We consider this information private and it will only be reported as part of an aggregate data report. 
 
 
1.Are You:  (Please Choose One)
2.What is your age? (Please choose one)
3.What race best describes you? (Please choose one)
4.Are you Hispanic/Latino? (Please choose one)
5.Are you: (Please choose one)
6.Do you have a family member who is in the military or is a veteran? (Please choose one)
7.Credentials (select all that apply):
8.Highest Level of Education:
9.This event has increased my knowledge and/or skill.