Step 1 of 2 50% Contact InformationName* --None--Mr.Mrs.Ms.Mx.Dr.Prof.Rev.SisterSecretarySenatorDelegateCongressman Prefix First Last Work Email* Work Phone*Position Title* Work Address*-Must be a school in Maryland- Street Address Address Line 2 City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County*Please click here to select your county.Allegany CountyAnne Arundel CountyBaltimore CityBaltimore CountyCalvert CountyCaroline CountyCarroll CountyCecil CountyCharles CountyDorchester CountyFrederick CountyGarrett CountyHarford CountyHoward CountyKent CountyMontgomery CountyPrince George’s CountyQueen Anne’s CountySaint Mary’s CountySomerset CountyTalbot CountyWashington CountyWicomico CountyWorcester CountyHow did you hear about the Campaign?*Past participationColleague/co-workerSupervisorLocal school/school personnelDirectly from Children’s Mental Health Matters! CampaignMHAMDMCFSocial MediaOtherIf selected other, please describe: Connect With Your SchoolWebsite Facebook Handle Instagram Handle Twitter Handle Planning for 2022Please share any plans you may have already for participating in the 2022 Campaign, including how you plan to utilize digital and physical materials (if made available):*Please share your event details in space below so we can add to our Events Calendar: School InformationSchool NameTotal Student PopulationTotal Number of StaffType of SchoolIf selected Other School - specify Early Childhood Education CenterPublic Elementary SchoolPublic Middle SchoolPublic High SchoolPublic - Other (please specify)Charter SchoolPrivate School (including Church Exempt & Montessori)Non-Public Special Education SchoolHome Instruction Program