Narconon Drug Prevention and Education: An Effective Approach


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You may also call 604-873-1762 from 8am to 11pm 7 days a week to speak with a presentation coordinator.

Contact Information:

Last Name:

First Name:

M.I.

Address:

City:

State:

Zip Code:

School Name:

Phone:

E-mail:

Grade Levels:

# of Students:

Prevention History:

Has your school ever had a drug prevention program? yes no

If so, what kind of program ?

Was it a fee-for-service or a free-of-charge program ? fee-for-service free-of-charge

What effect did this program have ?

Were you satisfied with the outcome of the program? yes no

Does your school have any alcohol/drug-related problems that you are aware of? yes no

If yes, please describe them:

Other Information:

Does your school want more presentations about drugs/alcohol ? yes no

Please describe briefly what is going on with yourschool right now.
Also add any other information that we should know (best time to call, etc):

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