Webinar: Building Your Smoke-Free Housing Program

Participant Information

Please tell us a little bit about yourself.

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* 1. First and Last Name

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* 2. Email Address

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* 3. Phone Number

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* 4. Organization

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* 5. Job Title

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* 6. Has your organization/community received any of the following grants? (check all that apply)

Communities Putting Prevention to Work (CPPW)

Community Transformation Grant (CTG)

Neither

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* 7. Is your organization/community currently working on smoke-free multi-housing?

Yes

No

Not right now, but we plan to begin work in the next year