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 conrm that your organization supports the U.S. Consumer Product Safety Commissions 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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