WISH Smoke Free Dining guide ...


           Please add our restaurant to your Smoke Free Dining guide
           Please send info on converting to smoke free profitably.
 
Restaurant Name
 Contact Name
Street Address
Address (cont.)
City
County
State
Zip
Phone Number
FAX
E-mail
Web Address
Cuisine #1
Cuisine #2

          Type of service:  Fast Food  Table Service

          Dining Areas:  % Nonsmoking  % Smoking

              Bar Areas:  % Nonsmoking  % Smoking

          Waiting Area:  % Nonsmoking  % Smoking

          Days of operation:  Mon  Tue  Wed  Thu  Fri  Sat  Sun

          General Hours:  Breakfast  Lunch  Dinner

          Special Hours:

         

          Do you provide entertainment?  Yes  No

          What type? 

          Days:  Mon  Tue  Wed  Thu  Fri  Sat  Sun

          Comments:

         

          Does your city have a smoke free ordinance?  Yes  No

          If so, is your restaurant required to be smoke free?  Yes  No

          Do you favor or oppose local smoke free ordinances?  Favor  Oppose

          Do you favor or oppose statewide smoke free laws?  Favor  Oppose

          Are you a WRA member?  Yes  No

 


Jack E. Lohman, Founder
Wisconsin Initiative on Smoking and Health
Copyright © 2001.   All rights reserved.
Revised: July 30, 2004