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STAND Interest and Participation Survey
Name:
Address:
City:
State:
Zip Code:
Phone:
Date of Birth:
E-mail Address:
Are you a full time student?
Yes
No
High School
OR
College / University
Name of School /
College / University:
Year in School:
Graduation Date:
Do you work?
Yes
No
If yes, place of employment?
Please indicate which areas interest you the most:
Advertising / Publicity
Communications
Planning / Organizing / Coordinating Activities
Recruiting
Education / Disseminate Information
Advocacy
Student Government
Writing / Editing
Do you have any special talents or connections to resources or people that would be supportive to the mission of STAND?
Yes
No
If yes, please state what resources:
What knowledge do you have about drugs, drug policy, laws or legislation?