SADD Chapter Registration

Joining SADD means joining hundreds of thousands of young people across the country who are dedicated to saving lives and making good, healthy decisions. Once you send in this form, we will send you a packet of appropriate information along with your SADD Membership Certificate. It is very important for chapters to register with the SADD National office every year. Please be sure to fill out this form completely. All SADD chapters must reregister every year. Send in your registration form now and you will receive a FREE Gift! If you prefer, you may download a pdf copy of the registration form and mail or fax it to us. (* required fields):
Please select one*:	Brand new chapter registration Chapter renewal
SADD Chapter Name*:
Check all that apply:	School Community Center Other Elementary School Middle School High School College Urban Suburban Rural Private Public
# of Active Members in SADD*:
Total # of Students*:
Grade Levels*:
Year SADD started*:
Principal or Director's Name*:

School Address Street (No PO Box)*:
School City*:
School State*:
School Zip Code*:
School County:
Phone*:
Fax*:
Web site address of school:

Shipping Address Street (no P.O. Box):
Shipping City:
Shipping State:
Shipping Zip Code:
Shipping County:

Advisor's name*:
Advisor's title*:	Teacher Counselor Coach Nurse Law Enforcement Officer Parent Community Leader Clergy Other
Advisor's Home Address (no P.O. Box):
Advisor's City:
Advisor's State:
Advisor's Zip Code:
Advisor's Home Phone:
Advisor's Office Phone*:
E-mail address of advisor*:

Additional Advisor's name:
Additional Advisor's title:	Teacher Counselor Coach Nurse Law Enforcement Officer Parent Community Leader Clergy Other
Additional Advisor's Home Address (no P.O. Box):
Additional Advisor's City:
Additional Advisor's State:
Additional Advisor's Zip Code:
Additional Advisor's Home Phone:
Additional Advisor's Office Phone:
E-mail address of additional advisor:

Chapter President :
E-mail address of Chapter President:

If this is a brand-new chapter registration, how did you hear about SADD?*	Web site Newsletter Other If other, please specify: