Smoking Cessation Training Survey

Please complete the following questions and select your preferred date to attend the training.  Please note places will be filled on a first come first served basis.

The Smoking Cessation Programme is endeavouring to ensure that all sections of the community across Birmingham have been able to access and utilise the programme. The equalities data we are asking you to provide will be used for statistical monitoring purposes only. All information will be aggregated and not used to identify any one individually. It will be kept securely and in confidence.

Your Details

1.Name(Required.)

2.Job Title(Required.)

3.Organisation(Required.)

4.Email Address(Required.)

5.Contact Telephone Number(Required.)

6.BVSC is committed to ensuring its programmes are accessible to all participants. Do you have any accessibility requirements to support your attendance to this event?

Your Work

7.Which area(s) of Birmingham does your work cover?

8.Which of Birmingham’s communities do you work with?

9.Which of the following best describes your interest in further involvement with the Smoking Cessation programme?

I would like to apply for the grant funding for my organisation and to join a one-day Level 2 training session.

I would be interested in joining the volunteer pool to attend community engagement events.

I would like to take what I’ve learned in the training back into my own practice.

Preferred Date and Time

All sessions will take place at BVSC’s office (Latham House, 33-34 Paradise Street, Birmingham B1 2AJ), except the two sessions on Monday 9th June, where the venue is currently to be confirmed.

Please note that each session has a limited capacity and places will be allocated on a first come, first served basis.

Thank you for completing this survey for the Smoking Cessation Training Programme. We will be in touch shortly to confirm your place at your session. If you have any questions, please contact healthandsocialcare@bvsc.org.