Northampton Prevention Coalition Membership Registration Form
The mission of the Northampton Prevention Coalition is to collaboratively initiate, coordinate, and sustain prevention and intervention efforts that reduce teen substance use in the City of Northampton.

Coalition members support the mission of the Coalition and participate in Coalition activities. Coalition members participate by:

• Attending coalition meetings
• Working on a workgroup or subcommittee
• Volunteering at an event
• Helping out with data entry
• Talking to your friends and neighbors about the coalition
• Advocating for the coalition in the media and with decision makers
• Learning about our plan for reducing youth substance use
• Advocating for public policies that support adolescent health, well-being and substance use prevention
• And more!

By filing out the form below, you are affirming that you are a member of the Coalition and are in support of the Coalition’s mission.
Name *
Address *
Email *
(if applicable)
Clear selection
I represent the following community sector(s):
check all that apply
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