Vandal Weight Loss Program

Please fill out the following information for the Vandal Health Weight Loss Program:

First Name

Last Name *This question is required.

Height

Current Weight

Age

Goal Weight (in pounds)

Phone Number

Email Address (@vandals.uidaho.edu) *This question is required.

I understand that this program is designed for University of Idaho students with 20 or more pounds to lose who are ready to make lifestyle changes in order to reach their weight loss goals.