Generation FREE Activity Team Report - The Partnership for a Healthy Mississippi

Generation FREE Activity Team Report

Organization Name*
Team Name*
Sponsor's Name*
First Last
Phone Number
Email Address*
Date of Activity*
Shipping Address (No PO Boxes)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County*
MTFC Director*
If your MTFC isn't listed put their name here. If they are listed put N/A
Title of Activity*
Activity Topic*
Comments/Suggestions
Did media cover the event?
- Yes
- No
Which media outlets covered the event?
# of FREE team members who participated in the activity*