Deadline to submit this report: 5 p.m. Friday, January 13, 2016.

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* 1. School Name and Address:

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* 2. Estimate the total number of activities completed during the Holiday Campaign:

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* 3. Please highlight several of the activities completed during the Holiday Campaign:  Also, include in the list how the club thanked students after the campaign for driving responsibly during the holidays and returning safely to school in 2016.

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* 4. Estimate the total number of students reached by this campaign:

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* 5. Student Leadership- Number of students who helped plan and implement the activities:

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* 6. Did your school/club received any media coverage during the campaign? (not required as part of the campaign)

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* 7. Please select the type of media coverage your school/club received (if any) and select all that apply:

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* 8. Did your school/club receive any funding/donations during the campaign? (not required as part of the campaign)

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* 9. Please list funding/donations (if any):

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* 10. By submitting this form, I verify that the report is accurate.

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