WE WOULD LIKE TO KNOW ABOUT YOU

To help us provide what you need to help create a drug-free world, please fill in this questionnaire. Information you provide is kept confidential and is never shared.

First Name

Middle Initial

Last Name

Organization/Institution Name

Job Title

Street

City

State/Province

Postal/Zip Code

Country

Phone

How did you hear about Foundation for a Drug-Free World and the Truth About Drugs program?

What best describes your profession?

If you are teaching, what is your main subject area?

Grade Level(s)

Age(s)

Do you teach drug education? If so, select one:

In what sector do you teach drug education?

How many drug education classes do you teach per week?

Do you prefer:

Is there any additional drug education information you would like to have?

What have you found to be most effective or useful in the Drug-Free World materials?

Is there anything else you would like us to know at Foundation for a Drug-Free World?

Je désire recevoir le bulletin d’information de la Foundation for a Drug Free World (Fondation pour un monde sans drogue).

J’accepte les conditions d’utilisation et l’avis de confidentialité. [Qu’est-ce que c’est ?]

WE WOULD LIKE TO KNOW ABOUT YOU

QUI SOMMES-NOUS ?

INFORMATION SUR LA DROGUE

PASSEZ À L’ACTION

NOUVELLES

SOUTIEN DE LA FONDATION