GA First 2000 Days Champion Agreement
Please complete this form to commit to serving as a First 2000 Days Champion in Georgia. Champions play key roles in community outreach. They are trained to give the First 2000 Days presentation, suggest opportunities to give presentations and are presenters themselves. These community influencers carry the First 2000 Days message with them in their professional and personal life.

Please contact Meagan Jackson at GEEARS with any questions (
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Georgia First 2000 Days
First and Last Name *
Email Address *
Mailing Address (where your toolkit will be shipped) *
Phone Number *
Title and Organization/Company
Professional or Volunteer Organization Affiliations *
How did you hear about the campaign? *
I believe the first 2,000 days of a child's life are important because... (short paragraph response) *
I am committed to participating as a Champion in the following ways: (check the items your organization can commit to) *
Age Range *
County of Residence *
City of Residence *
Please submit a professional photo that may be shared in First 2000 Days promotional materials to Meagan Jackson at *
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