REGISTRATION - Project Here

Project Here Registration Form

Massachusetts public middle schools who serve students in grades 6, 7 or 8, and coalitions/community partners interested in using Project Here are asked to provide the following registration information. This information allows Project Here staff to contact you to provide technical assistance and training on how to access and use the Project Here Online Toolkit and Project Here Games. *If you do not see your school name on the drop-down list, please contact info@projectherema.org*

Are you registering on behalf of a:*

School Name*
School District*

Name of Coalition/Community Partner Organization*
Must be a Massachusetts based substance use prevention coalition or community organization that serves students in grades 6, 7 or 8.
Name(s) of school(s) and school districts served by your organization*
School must be a Massachusetts public school serving students in grades 6, 7 or 8.

Organization Address*
Street Address Address Line 2
City/Town*
State*
Zip code*
County*
Website*

First Name of Primary Contact*
This individual will be the main point of contact between Project Here staff and your district. Ideally, this individual is a District Health and/or Wellness Coordinator, school principal, health educator, etc.
Last Name of Primary Contact*
Title/Position of Primary Contact*
Primary Contact Email*
Contact phone number*
Extension
Additional Contact Information
Please use "+" to add additional users of Project Here resources (I.e. other health/PE/science teachers at your school, guidance counselors, school nurse etc.)
First Name Last Name Title/Position Email Phone number Extension

Were you referred to Project Here by an educator who is currently using Project Here resources in their classroom?*
I was referred by:*
Name School City/Town

Register for Project Here

Project Here Registration Form

Step 1 of 7

First Name	Last Name	Title/Position	Email	Phone number	Extension

Name	School	City/Town