Book a Fentanyl Fathers Assembly Today!
Please complete your registration for a Fentanyl Fathers Assembly below. Your response will be recorded, and requested assembly dates for booking will be accommodated on a first come, first serve basis. Please reference our central assembly calendar here  before proceeding. Thank you for taking this important step in driving awareness about fentanyl and counterfeit pills. Together we can help save lives!
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Email *
What is your first and last name? *
What is the name of the school or community event location you're submitting this booking request for? *
Is this a high school, middle school, or community event request?  *
Please list all of the grade levels that will be in attendance for the assembly (i.e. 9th-12th grades, Juniors & Seniors, etc.). If this is a community event request, write N/A. *
What date would you like to schedule this assembly? *
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What time would you like the first assembly to start? *
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Phone *
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