Passport to Wellness Registration

Question Title

* 1. Name

Question Title

* 2. Email address

Question Title

* 3. You are a

Student

Staff

Faculty

Question Title

* 4. If you are a student and receiving extra credit from your instructor, please state your instructor's name and class

Instructor's name

Class

Question Title

* 5. Please indicate which session(s) you plan on participating in;

	Breathing/Relaxation Exercises (rm 7108)	Healthy Foods, Healthy Minds (rm 7107)	Laughing Circle (rm 7104)	Yoga (rm 7101)
11:00 - 11:25	11:00 - 11:25 Breathing/Relaxation Exercises (rm 7108)	11:00 - 11:25 Healthy Foods, Healthy Minds (rm 7107)	11:00 - 11:25 Laughing Circle (rm 7104)	11:00 - 11:25 Yoga (rm 7101)
11:30 - 11:55	11:30 - 11:55 Breathing/Relaxation Exercises (rm 7108)	11:30 - 11:55 Healthy Foods, Healthy Minds (rm 7107)	11:30 - 11:55 Laughing Circle (rm 7104)	11:30 - 11:55 Yoga (rm 7101)
12:00 - 12:25	12:00 - 12:25 Breathing/Relaxation Exercises (rm 7108)	12:00 - 12:25 Healthy Foods, Healthy Minds (rm 7107)	12:00 - 12:25 Laughing Circle (rm 7104)	12:00 - 12:25 Yoga (rm 7101)
12:30 - 12:55	12:30 - 12:55 Breathing/Relaxation Exercises (rm 7108)	12:30 - 12:55 Healthy Foods, Healthy Minds (rm 7107)	12:30 - 12:55 Laughing Circle (rm 7104)	12:30 - 12:55 Yoga (rm 7101)