2013 Maintain, Don't Gain Challenge
BGSU ID #
Are you participating as an individual or as part of a team?
If on a team, please list your teammates:
Have you participated in a BGSU wellness program before?
If yes, please specify
What is your current weight?
What is your height?
On average, how many days per week do you engage in at least 30 minutes of physical activity?
0-1 days per week
2-3 days per week
4-5 days per week
6-7 days per week
On average, how many servings of fruits and vegetables do you consume on a daily basis?
8 or more
Should be Empty: