Be a Champion Application 2015

4. Have you been a Priority Health Champion before?

• Yes
• No

10. How did you hear about the Champion program? *This question is required.

• Friend
• On WOOD TV8 or WOTV4
• On WXYZ
• Local newspaper
• Other: Please enter an 'other' value for this selection.

11. What sports or activities do you participate in? (check all that apply) *This question is required.

• Bike
• Run
• Triathlon
• Walk
• Wintersports
• Watersports
• Other: Please enter an 'other' value for this selection.

14. How long would you say you have been participating in this activity? *This question is required.

• Just beginning
• 2-5 years
• 6-10 years
• 10+ years