Governor’s Civic Engagement Award (School)

An Official Pennsylvania Government Website

Department of State

Step 1 of 2

School Name

*

County 1

County 2

County 3

School Address

*

City

*

Zip Code

*

Teacher First Name

*

Teacher Last Name

*

Teacher Email

**

Teacher Phone

*

Alternate School Contact

*

Alternate Email

*

Alternate Phone

*

Number Eligible Students

*

Number Registered

*

Percent Registered

*

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