2017 Firm In-House Challenge Submission Form
Here is the form that you will need to fill out for your in-house challenges for Designed Wellness. First, a brief recap of the program and the deadlines. If you have any questions, please feel free to email Lindsay Simone (firstname.lastname@example.org) or Michael Neeper (email@example.com).
We are launching a new firm-level program challenge designed to engage you and your firm in your own in-house programming. By “in-house” programs we mean programs of your own design that are separate from Designed Wellness features. This can include your own Lunch & Learns, health fair, 5K walks/runs, charity activities, in-house weight, exercise, nutrition challenges, wellness committee activities, etc.
The firm-level in-house program challenge will last from January 2017 to July 2017.
You create your own in-house program or participate in one of the four Trust-sponsored activities and submit a short write-up to be entered to win the firm prize. You can submit up to 3 program write-ups for the drawing (one for each month of the Challenge). Write-ups will be submitted to our consultant, OWLS, for prize selection and should include: an explanation of your program, how you administered it (i.e. budget, resources, materials, and planning methodology), the level of participation you had, and how you plan to use the award money. A write-up template will be provided to you once the Challenge begins.
Firms that participate have the opportunity to earn entries into a raffle for a firm-level award of up to $250 per firm. We hope that these incentives will entice you and your staff to create and participate in as many in-house wellness activities as possible during this period of time. Winners will be selected in each three firm size categories (2 to 50; 51 to 99; 100+). The Prizes will be the following for EACH firm size segment: $250 GRAND PRIZE and (3) $150 prizes. Grand Prize winners selected based on criteria: (1) number of activities, (2) participation (based on firm size), (3) diversity of activities, and (4) plans for using award money. The $150 prize winners will be selected via a randomized drawing.
1. Firm Name
2. Champion Name
4. Total Number of Employees in the Firm
5. What was the activity that you did with your employees (describe in enough detail so that we can accurately assess your effort)? Limit to 300 words.
6. What type of activity was it?
Topical Challenges (e.g., exercise, Walk/Run for charity – reach targets/goals, water drinking/nutrition)
Benefits and Environmental Supports (e.g. Hosting an in-office potluck (healthy food), Offer free, healthy snacks, Incentivize smoking cessation)
Employee Enrichment and Education (Events/Activities; e.g. Conduct own Lunch/Learn, Encourage, walking, biking, or shared transportation to/from work)
Team-Oriented/Social (e.g., Set up a sports league, Have themed outfit days, Collaborate with other ACEC firms, Make a community garden)
Wellness Committee (e.g., Set-up a wellness committee, Training and/or retreats for wellness committee, Schedule committee meetings)
Lunch/Learn (e.g., conduct own, bring in speaker)
Collaborate with other ACEC firms
Hold a health fair
Created flexible work hours
Offer standing/walking desks
Make a community garden
Hold an employee field day
Hold a book club
Other (explain below)
8. What was the timeframe of your activity (i.e. one day, week)? Please provide specific dates if applicable.
9. What was your budget for this activity?
10. What resources or materials did you use for this activity?
11. How many employees participated?
12. How was the program received by employees? Please provide specific feedback; e.g., evaluation forms, testimonials, etc.
13. Will you do the program again?
14. If you win the award for this activity, how would you plan to use the prize money?
15. Any further comments or notes?
Do Not Fill This Out