Witness the Fitness

Nomination Form

Catch your co-workers in the act of fitness!
Let’s get moving! If you “Witness the Fitness” with a co-worker, please fill-out the form below. The exercise can be walking, stretching, stairs, and more. By nominating your co-worker, they will have a chance to win a $50 gift card and receive a certificate. We will have 1 winners per month. If you have any questions, please contact Stephanee Phillips, Wellness Coordinator, at Wellness@CharlotteCountyFL.gov

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* 1. Nominee's Information:

Name (First and Last Name) *

Email Address (if known)

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* 2. If known, Which of the following organization is your nominee apart of:

Board of County Commissioners

Property Apprasier

Tax Collector

Punta Gorda Airport

Peace River Water Authority

Supervisor of Elections

Clerk of Courts

Court Administration

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* 3. What type of physical activity did you see the nominee doing?

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* 4. Where did you see physical activity take place?

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* 5. The month are you nominating:

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* 6. Your Information:

Name

Email Address

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* 1. Nominee's Information:

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* 2. If known, Which of the following organization is your nominee apart of:

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* 3. What type of physical activity did you see the nominee doing?

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* 4. Where did you see physical activity take place?

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* 5. The month are you nominating:

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* 6. Your Information:

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* 7. Do you have any comments or feedback for Wellness at Work?