JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
No Smoking Sign Request
Thank you for doing your part in keeping your building smoke-free! We offer various free signs that you can place in your complex so that people are aware of the Smokefree Ordinance.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Below are the free laminated sign designs that you can request to order (Each design is 8.5x11):
Below is the metal sign that is available to order (limit 2):
Do you need a metal sign? (Metal signs ordered have to be picked up at the Public Health Department via appointment)
*
Yes
No
Other:
How many metal signs would you like?
*
1
2
Which laminated sign(s) are you requesting to order?
*
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Option 7
Required
How many laminated signs will you need for each design option chosen?
*
Your answer
City where the signs will be posted?
*
Oakland
Unincorporated area (Castro Valley, Fairview, San Lorenzo, Cherryland, Ashland)
Alameda
Emeryville
Other:
What is the mailing address for the laminated signs?
*
Your answer
What is the best contact number to confirm your sign order?
*
Your answer
Email address
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms