Survey - Indiana FFS Survey - American Lung Association

Please fill-out the following survey to have your Freedom From Smoking clinic posted online.

*1.	Question - Required - What is the name of the building where the sessions will take place?
*2.	Question - Required - What is the address of the building?
*3.	Question - Required - What time does the session start?
*4.	Question - Required - What time does the session end?
*5.	Question - Required - Please list the dates of each session.
*6.	Question - Required - What is the fee to attend? (If there is no fee, type $0.00)
*7.	Question - Required - Provide all contact information for registration or other purposes. (Contact name, phone number, email)
8.	Question - Not Required - Please explain any other details we should know about before posting.