Red Ribbon Week Patch Activity Report

Last Updated: Thursday, March 28, 2019

Program Dates: July 1 - November 30

This form certifies your completion of all program requirements. Complete the "Activity Report" by November 30 to receive your DEA Ribbon Week Patches.

Council Name *

Scout Troop or Unit Number *

Mailing Address (to send patches) - No P.O. Box or APO, Mailing address should be a physical location where Troops and Units can receive patches. *

City *

State *

Zip Code *

Troop's Email Address *

Number of Boy Scouts or Girl Scouts who attended the anti-drug prevention session: *

Number of Boy Scouts or Girl Scouts who took the drug free pledge: *

Number of patches requested for your troop or unit (only one patch per scout per program year): *

Approximately how many participants attended your Red Ribbon Week activity? *

Did you partner with anyone? *

Please describe all the Red Ribbon Week activity/event(s) your troop or unit sponsored this program year. *

If so, please mark all that apply:

If other, please specify:

Please describe the anti-drug prevention education session(s) attended by the scouts (ie. discussion, lecture, etc.) during this program year. *

Are you planning to participate in next year’s Red Ribbon Week? *

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Red Ribbon Week Patch Activity Report

Program Dates: July 1 - November 30

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