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School Registration
Being a participating school with the Focus Program will enable your students to be actively involved in reducing the incidence of risky behaviors among their peers.

By completing this form, you will receive information and technical assistance for your school’s prevention efforts from the Focus Program director, Alabama Department of Public Health, and other community agencies.

School Name:
County:
School System:
Facilitatorís Name:
Principalís Name:
School Address:
City:
Zip:
Phone:
Fax:
Facilitator's Email Address:
Principal's Email Address:
Number of Focus Program Members:
Status:      Years:
Implemented As:
As Part Of:      Name:
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