Enclosure (4) to COMDTINST 5350.22B
Partnership In Education Events Form
EVENT:
Event Name:
Date:
Time:
Location:
Comments:
SCHOOL:
School Name/Address/Phone:
Level
_____ K-5
_____ Community College/Tech School
_____ 6-8
_____ Graduate School
_____ 9-12
_____ Life long learning
_____ Undergraduate
_____ Other
Contact Person(s):____________________
Total number of volunteers:_______________
Total volunteer hours:_________________
Students
____________
Adults: _____________
Teachers: __________
Occasion:
_______ Speech
_______ Career Day
_______ Ceremony
_______ Banquet
_______ Lecture
_______ Other
Coast Guard Unit: __________________________________
PIE Coordinator: _______________________
Phone # _______________
Send to: Commandant (G-H), FAX # (202) 267-4282
Phone: (202) 267-1562, or E-mail via the G-H website
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