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Apply to become a Priority Health Champion 2020

Apply to become a Priority Health Champion

This question requires a valid email address.
4. Is this your first year being a Priority Health Champion?
Gender *This question is required.
This question requires a valid number format.
Using the maps below, what area of Michigan are you from? (select one) *This question is required. Please select one of the following images.
How often do you do physical activity? *This question is required.
Are you a Priority Health or Spectrum Health employee? (not a requirement for the program) *This question is required.
Do you have Priority Health insurance? (not a requirement for the program) *This question is required.
Are you registering anyone under the age of 18? *This question is required.
Champion kid #1
Gender *This question is required.
Add another Champion kid?
Champion kid #2
Gender *This question is required.
Add another Champion kid?
Champion kid #3
Gender *This question is required.
Add another Champion kid?
Champion kid #4
Gender *This question is required.