Quit and Win! $200

Are you or one of your family members one of the many tobacco users in Somerset County
who would like to start a tobacco free lifestyle? Call today for the dates of the program and try to win up to $200 and other great prizes!

Here is how it works:

Tobacco users register for Quit & Win with Somerset Heart Health through their local Quit Plan Training, at a health care site, work site or on line at www.somersethearthealth.org and quit tobacco use.

The program is FREE and open to Somerset County residents 18 years of age and older.

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Applications must be received by the start date of the program selected below.


Each participant chooses a helper who will offer support and verify that they stayed tobacco-free. (The helper can win up to $50.)


Each participant, that stays tobacco free for five weeks, is eligible for $200 prize drawing. All participants attending the celebration will be eligible for great door prizes.


To win you must be 18 years of age or older and and present at your local Quit and Win site Celebration held at the end of each session

Presented by: Somerset Heart Health

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Quit and Win! $200 (One form per person entered please)
	Your Name:
	Mailing Address:
	City, Zip Code:
	Day Time Phone Number: Evening Phone Number:
	E-mail:
	Work Place You are Registering Through:
	Please check the box of the QUIT AND WIN session you are planning to participate in:
	September 20, 2009 - Oct. 25, 2009 Nov. 19, 2009 - Dec. 24, 2009 Quit Date Must be after Sept 20 and on or before Nov 19, 2009 Feb. 14, 2010 - March 21, 2010 Quit Date Must be after Nov 19, 2009 and on or before Feb 14, 2010 May 9, 2010 - June 13, 2010 Quit Date Must be after Feb 14, 2010 and on or before May 9, 2010 Please make a selection
	Quit Date(between program dates):
	I have completed a Quit Plan through: Place an 'X' in the box of any or all which apply: My health care provider/health center Calling the Tobacco helpline 1-800- 207-1230 My local hospital My worksite Attending a Q&W Quit Plan Training Other
	Your Helper (Someone who will help you stay tobacco free. They can win up to $100 and other great prizes!)
	Your Helpers' Name:
	Mailing Address:
	City, Zip Code:
	Daytime Phone Number: Evening Phone Number:
	E-mail:
	Drop off the entry form at a quit and win work place or you can return it to: Somerset Heart Health P.O. Box 468 Skowhegan, Maine 04976 (fax 474-7473) Note: If you have not received the packet of information within 10 days of registering please call 474-7473