Steps to Becoming a No Place for Hate® School

Activity Fulfillment Form

Name of School:
Name of Principal/Director:
Address:
  City: State: Zip Code:
Contact Person:
Phone:
Fax:
E-mail:
Title of completed activity
(If applicable, please put activity #)
Description of Activity
(Who, What, When, Where, How)
Date Begun:
Date Completed:
Accompanying Materials:

Newspaper Articles
Photographs (With description including name of individuals and affiliations)
Video tape
Letters from local participants
Other (please specify):

Number of Attendees
(excluding organizers):
Organizer's Name:
Organizer's Address:
Organizer's Phone Number:
Was a Press Release sent out? Yes No