Re-Enrollment Form | Clean Air Campaign

Thank you for your continued interest in the Clean Air Schools program.

Being a Clean Air School means you are committed to helping create and maintain a healthier environment for successful teaching and learning. We appreciate your interest in continuing to use your school campus and community to increase awareness and involvement of The Clean Air Campaign's efforts to improve our air quality for our future leaders.

Thank you for your continued interest in the Clean Air Schools program.

School Name

School Street Address

City

County

Zip

Phone

Grade Level

School District

Primary Contact Name

Primary Contact Title

Primary Contact Phone Number

Primary Contact E-mail

Secondary Contact Name

Secondary Contact Title

Secondary Contact Phone Number

Secondary Contact E-mail

School Principal

Principal E-mail

We plan to implement at least one or more of the following program(s):

What group(s) at your school will implement the Breathe Easy toolkit (if applicable)?

How did you hear about us?

Are you a Georgia Safe Routes to School participant?