Housing Materials Order Form

Materials Order Form

Please select the free materials you need to support your smoke-free policy.

    Window Decals

    housing materials
    WINDOW DECALS
    SIZE 6" x 4"

    QTY
    Limit one per common use door in building

    Magnets - Recommended one per unit

    housing materials
    MAGNETS
    SIZE 3.5" x 2"

    QTY
    Small magnet mounted on card

    Key Chains

    housing materials
    KEY CHAINS
     

    QTY

    Double Sided Window Decals - Limit four per building

    housing materials
    Double Sided Window Decals
    "This is a smoke-free building"
    SIZE 8" x 6"

    QTY

     

    housing materials
    Double Sided Window Decals
    "This is a smoke-free property"
    SIZE 8" x 6"

    QTY

     

    housing materials
    Double Sided Window Decals
    "Smoking is not allowed within 25 feet of this entry way"
    SIZE 8" x 6"

    QTY

    Aluminum Signage - Limit two per building

    housing materials
    Aluminum Signage
    "This is a smoke-free building"

    SIZE 12" x 9"
    QTY
    SIZE 24" x 18"
    QTY

     

    housing materials
    Aluminum Signage
    "This is a smoke-free property"

    SIZE 12" x 9"
    QTY
    SIZE 24" x 18"
    QTY

     

    housing materials
    Aluminum Signage
    "Smoking is not allowed within 25 feet of this entry way"

    SIZE 12" x 9"
    QTY
    SIZE 24" x 18"
    QTY

    Smoke-Free Home Pledge Card

    housing materials
    Smoke-Free Pledge
    "Pledge to protect yourself and others from the health risks of secondhand smoke"

    QTY

    Property Information

    Number of Smoke-Free Buildings
    Approximate Number of Tenants
    Number of Smoke-Free Units
    Municipal Location of Smoke-Free Apartments

     
    Contact Information

    FIRST NAME
    LAST NAME
    COMPANY
    EMAIL
    ADDRESS - LINE 1
    ADDRESS - LINE 2
    PHONE
    CITY
    STATE
    ME - MAINE
    ZIP CODE
    Please upload your smoke-free policy or lease agreement/addendum.


     
    How did you hear about these resources?
    Would you like to be put in contact with your local District Tobacco Prevention Partner to help with policy change or implementation?

    YesNo
     
    Additional Notes:

    These materials listed above are only intended for Maine multi-unit housing properties. Breathe Easy reserves the right to limit the number of items provided per request. All items provided by our non-profit organization are free to Maine landlords, property managers and housing professionals with 100% smoke-free buildings. Supplies are limited. Please allow 2-4 weeks for delivery.

    We may request payment of postage for any order of metal signage provided or ask that interested parties make arrangements to pick up these materials direct from our office.

    Limited quantities of aluminum signage available. Breathe Easy will contact you in regards to the availability of this signage should we be unable to fill your request.