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“Take A Stand With The Minuteman:
Be Drug Free”

Student Workbooks: 

Would you want Civil Operations to assist with this presentation? 

Dates of presentation:
                               (Start to End) - **Required Field**

*Note:  Please estimate the numbers as closely as possible.

*Classes per day:                  *Hours of instruction per class: 

Number of students per class: 
                                          (separate students per class with a comma) 

Total number of workbooks requested: 


School Requesting Program: 

Teacher Name: 

School Mailing Address: 

City:       State:          Zip: 


Recruiter's Name:    

Recruiter Mailing Address:
 

Recruiter Phone Number: 

Materials needed:  Workbooks    DVD    Goggles    Pens     Brochures
                          Other: 

How do you want to receive your materials? 

                                                           

      

If you have any questions please contact the Civil Operations Program Manager at (334) 274-6306.  You can fax us at (334) 274-6300.


 DDR Office Info
 

Address:
1750 Congressman Dickenson Drive
Montg. AL  36109
ATTN: Counterdrug Program - Civil Ops

Contact Numbers
Program Manager:
Phone: 334-274-6306
Cell:  334-651-3031
Fax:  334-274-6300

 


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