Online Registration

May 21, 2008

If you have any questions, please call Diane Campbell at 207-622-7566, ext. 230 or dianec@mcd.org 

 

Those who register will be mentioned on our web site and in our newsletter.

 

 

 

 

To register for National Employee Health and Fitness Day, please complete the form below. 

                                                   * denotes a required field

Coordinator's Name:	*
Organization Name:	*
Address:	*
City:	*
State:	*
Zip:	*
Phone:	*
Fax:
Email:	*
Type of Organization:	Choose One Non-Profit Health Care Hospital State Government Federal Government School Manufacturing For-Profit Other *
Number of Employees:	*
Percentage of employees  estimated to participate in event?:
Has your company participated in NEHF before?:	Choose One Yes No
As the Coordinator of NEHF Day at your site, would you like to have your name and contact information listed on the web site so that other companies can contact you to find out what your site is doing or to share ideas?	Choose One Yes No