Directory of Smoke Free Places
Check back here as more and more join up!
Aims of the Award
Why we believe this issue is so important.
Understanding Smokers
Get to grips with what motivates smokers.
 
Find out about the best route to apply for the Award including the benefits, obligations and criteria.

Application for Franchise

Applicant's Information
Name of person making application:
Address:
Line 1
Address:
Line 2
Town:
County:
Postcode:
Telephone: STD:
Email:
Co-Ordinator Information (Check if same as above: )
Name of Co-ordinator:
Address:
Line 1
Address:
Line 2
Town:
County:
Postcode:
Telephone: STD
Email:
Organisation  
Type of organisation
 
Are you representing a Primary Care Trust or Group of Primary Care Trusts? Yes No
   
   
Check box if you wish certificates to be personalised with your logo.
(Note: you will need to provide your logo in electronic format for this. We will contact you with further information)
Financial Information  
TOTAL payable for franchise £
Check box if billing details are the same as for Applicant above.
Contact Name:
Address:
Line 1
Address:
Line 2
Town:
County:
Postcode:
Telephone: STD
Email:
How do you wish to pay
What is your purchase order number (where appropriate)
Privacy Agreement  

We wish to provide a register of franchisees which will be accessible to all franchise members only.

Please tick yes, if you consent to this.

 yes no

The National Clean Air Award is operated by the Roy Castle Lung Cancer Foundation, which is the only charity in the world dedicated to defeating lung cancer – the biggest cancer killer in the UK. We would like to send you information about the charity and its work.

Please tick yes, if you consent to this.

 yes no
 
 
 
 

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