N.O.T. (Not On Tobacco) Advanced Training

Location: White River Junction, VT
Dates: May 17, 2012
Times: 9:00 &#8211; 12:00
Cost: There is no charge for this training

Click here for complete details of this training

Please fill out the following information.

Participant Information:
Title	First name	Last name

Email Address

Email Address (again)

Organization or School Information:
Organization

School
(Pick 'none' if this doesn't apply.)
Other School

Other Supervisory Union

Street Address Line 1

Street Address Line 2 (Optional)

City

State	Zip

Work Phone Number

Work Fax Number

NOTE: So we can contact you in the event of cancellation, please provide your home phone number:
Home Phone Number (Please see note above)

Personal Information:
Organizational Role

Other Organizational Role

How did you hear about this training?

Other way you heard about this training if not in list above.

Please complete the following pre-assessment questions:
What are the greatest challenges you face in implementing a teen smoking cessation program in your setting?

What kind of technical assistance would help you to be successful?

When do you hope to hold your first session (fall 2010,/winter 2010/spring2011)?