Pledge Registration Form
On Monday, November 5, 2007, students, teachers, parents, community members, and all other safe school stakeholders throughout Michigan are being asked to make a Safe Schools Pledge. The goal is to get 100,000 signatures from those making the pledge. Sample pledge forms can be found on the Safe Schools Week Web page at www.safeschools.msu.edu or in the Safe Schools Week booklet distributed to Safe and Drug Free School Coordinators and school liaison/resource officers, or by contacting Mary Gager Anderson (see below).
To ensure that your school/group receives recognition at a press conference and is added to our count of those making the pledge, we are asking you to fill out the registration form below and fax the form back to the Safe Schools Initiative Workgroup. The Safe Schools Week Committee members are requesting this information for two reasons.
- The Committee will be forwarding a list of every schools participating in the pledge signing activity to the various television, newspaper and radio stations across the state.
- We will use the numbers you provide on this form to track progress in the 100,000 signature goal.
We will post your school (or group) name and the cumulative statewide number of pledges made on the Safe Schools Week web page (www.safeschools.msu.edu). The form can be faxed, mailed or emailed (with the information requested in the body of the email) – but must be received by the School of Criminal Justice at Michigan State University by Tuesday, October 30th a t 5:00 p.m. to be included in the information forwarded to the media.
Contact Person’s Name and Title: ________________________________Phone Number: (_____) - ________________
Email: ________________________________________
District: _____________________________________
City: ______________________________________
School (by Building) or Group: _____________________________________
Number of Individuals Making the Pledge: ___________
Person submitting this information: ___________________________________
For additional information contact:
Mary Gager Anderson, Safe Schools Program Coordinator
Michigan State University
1407 S. Harrison, Suite 323
East Lansing, Michigan 48823
Phone: 517.355.9648 / Fax: 517.432.0727
ande1033@msu.edu