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fitness membership subsidy

Please complete this form to receive a subsidy of up to $20 month for an eligible fitness membership and submit by the 15th of the following month.


How Did You Feel BEFORE Working Out? PLEASE SELECT AT LEAST ONE


 Tired  Unmotivated  Excited
 Energized  Stressed  Too Busy


How Did You Feel AFTER Working Out? PLEASE SELECT AT LEAST ONE


 Tired  Hungry  Healthy
 Relaxed  Happy  Like Death

 Walk  Run  Stairs
 Elliptical  Bike  Weights
 Swim  Racquet Sports  Sit In The Cafe

 Other