Name of School

Phone Number of School

Address

City

State

Zip Code

Name of S4S Advisor

Title of S4S Advisor

Advisor's S4S Email

Phone of SUDS4Students Advisor

Why do you need to be a SUDS4Students School?

Location of the SUDS4Student product closet. Not, the address, but where within the school where will you store the product?

What process will you use to confidentiality identify students?

What process will you use to ensure confidentially of distribution of the products to students?

SUDS4Students needs to know the number of students you are requesting for. How many students are you requesting supplies for?

Terms and Conditions

TERMS AND CONDITIONS: As the SUDS4Students Advisor at your school you agree to the following:   -  Every 6 month application (if there is a no new application received SUDS4Students will assume that there is no longer a need at your school)   -  I will be the single point of contact for SUDS4Students at the school   -  I will work with the administration, teachers, and staff with the school to ensure that there is a confidential method to identify the students that would benefit   -  I commit that the confidentially of the students that receive SUDS4Students products will be maintained to only those administration, teachers, and staff that need to know. Most importantly, I commit that to the best of my ability that the confidentiality of the student is protected from other students.   -  I will supervise distribution of supplies to a student and ensure these distributions will take place in a location that will allow the student to maintain confidentiality and privacy. Distribution of supplies to deserving student should never take place where other students could witness, and other students should never be a part of the SUDS4Students distribution. Ex. Student office workers should never deliver the supplies to the receiving student.   -  I will maintain a secure and discreet location to store the products   -  Within the best of my ability I will prevent misuse and abuse of the SUDS4Students distributions allowing supplies to only be given to identified students in monthly distribution for their individual need

Agree to Terms