Onsite Wellbeing Program Request Form

Complete the request form if you are interested in bringing any of the programs, services or events listed on the Employee Wellbeing website found under Wellbeing Initiatives>Onsite Programs and Services (i.e. weight management, training, webinars etc...) to your building. Be sure to work with your Building Principal or Building Supervisor for activity approval.

School or service location:
Today's date: / MM / DD YYYY
Requested by: First Last
Requester's email
Requester's position (i.e. Principal, Director, Wellbeing Champion, Teacher, ect...)
Name and description of service requested:
Start date of service requested (*Note, all requests must be made at least 4-6 weeks in advance): / MM / DD YYYY
End date of service requested: / MM / DD YYYY
Start time of service requested: : HH MM AM/PM
End time of service requested: : HH MM AM/PM
Approximate number of attendees: (*Note, some activities require a minimum number of participants)
How will this service be paid for?
Additional Comments: