Monday, 6 February

Contacts & Booking Details

Any of the services that we provide are accessible by telephoning the freephone number or by filling out an online booking form.

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Application Form

Smoke-free Haringey Awards

Please fill in your details on the form below to apply for a Smoke-free Haringey Award.

Name of Applicant*


Business Name*


Address*


Postcode*


Telephone*

Email*

  
Apply by post

If you would like to post your application, please download, print and complete the form and send to:

Caroline Hulett
Smoke-free Haringey
Block 6, 1st Floor
St Ann's Hospital
St Ann's Road
Tottenham
N15 3TH

Download Form



Type of premises:
  ,     (e.g. office, factory etc)
 
 
  ,     (e.g. hair dresser, shop, hotel)

Number of emplyees:
 
 
 
 

Is smoking permitted anywhere inside your premises?
  ,  
 

Does your business/organisation provide exterior smoking areas?
  ,  
 

Do you have a separate written policy regarding smoking?
         

Does your business/organisation offer appropriate stop smoking information and support to employees that may wish to quit?
         

If the answer is no, would you like further information about information and support that is available locally?
         

Where did you hear about Smoke-free Haringey?
 
 
 
  ,