Pool Safely Campaign
c/o Finn Partners
Attn: Jessica Reape
(202) 667-0901
jessica.reape@finnpartners.com
Application for Recognition as a
Pool Safely Campaign Safety Leader
Date
Organization Information
Organization Name: Street:
Contact Name/Title: City, State, Zip:
Contact Phone: Email:
Drowning Prevention Water Safety Family/Children’s Safety
Press Release/Media Social Media Engagement Campaign Content Distribution
Host Event Meeting Material Co-Branding Event Attendance Support
Take the Pool Safely Pledge Other:
Focus of Organization
Details
Description of Activity:
Audience Reached:
Link(s) to Activity:
Plans for Future Activity:
Qualifying Activities
Acknowledgement
By signing this form, you conrm that your organization supports the U.S. Consumer Product Safety Commission’s Pool Safely
Campaign and has engaged in the level of activity required as a Campaign Safety Leader.
Contact Signature Date
Please send the completed form to Jessica Reape at Finn Partners via email at jessica.reape@finnpartners.com
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