Smoke-Free Housing Registry Form

 

Register your Smoke-Free Property with MOTAC today!

Housing Information

• Property Name
• Property Address/City/State
• Number of Smoke-Free Buildings
• Number of Smoke-Free Units
• Total Number of Properties That You Own

Contact Information

• Contact Person
• City
• State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY         
• Zip
• Phone Number
• Best Time to Reach You
• Fax Number
• Email
• How did you hear about MOTAC?
• Comments or Questions?

© Copyright 2010 Metro Omaha Tobacco Action Coalition.

70% of renters in Douglas County say they are more likely to choose a non-smoking building over a similar building that allows smoking.