Air Quality Flag Program Registration Form

Name of Organization:
Grade Levels: (for schools only)
Address:
City:
State:
Zip Code:
County:
Telephone:
*Name of Flag Coordinator(s)
(separate using commas)
*Flag Coordinator E-mail Address:
*Flag Coordinator Telephone:
Is this a new or an existing program?
*If the Flag Coordinator changes, please send the new name and contact information to Donna Rogers at rogers.donna@epa.gov