Organization Specific Sector Name and Role Contribution to MOU in Organization Coalition Attached (describe Sector Name (full name active participation (Note by of (first and in coalition specific checking) last name) organization to the member) Youth (an individual18 or and younger) individual's role) Parent Business Media School Youth-Serving Organization Law Enforcement Religious or Fraternal Organization Civic or Volunteer Group Healthcare Professional State, Local, or Tribal Governmental Agency with Expertise in the Field of Substance Abuse Other Organization Involved in Reducing Substance Abuse
Sector Sector Name (first and last name) Organization Name and Role in Organization (full name of organization and individual's role) Specific Contribution to Coalition (describe active participation in coalition specific to the member) MOU Attached (Note by checking) Youth (an individual18 or younger) Parent Business Media School Youth-Serving Organization Law Enforcement Religious or Fraternal Organization Civic or Volunteer Group Healthcare Professional State, Local, or Tribal Governmental Agency with Expertise in the Field of Substance Abuse Other Organization Involved in Reducing Substance Abuse