New Customer Registration Form

AHC New Innovator Application

What is an AHC Innovator? Innovators contribute to OSU - America’s Healthiest Campus®- by communicating, engaging, and collaborating within their departments. Encouraging healthy lifestyles while at work- where we spend most of our time - benefits OSU’s employees, students, and communities. Innovators provide the tools, resources, and peer support necessary to facilitate healthy lifestyle choices with their colleagues.
Who can be an AHC Innovator?

Enthusiastic and committed Innovators comefrom all fitness levels, education levels, and positions.

Are you ready to become an Innovator? If so, take the first step in filling out this application form.
CWID (A + 8-digit number)*
Please provide your campus-wide ID starting with A (Ex: A1234567).
Full Name*

First NameLast Name
Title:*
Department/Location (Type Full Department Name):*
No. of Employees in Department:*
Employment Type:*

FacultyStaff
Office Phone:*
E-mail*
This is the address we will use to send reminders about the event.
Are you in good standing with the university?*

YesNo
Have you ever been placed under corrective action at OSU?*

YesNo
If you responded yes to the previous question, when?
Select each to agree to terms. I UNDERSTAND THAT I WILL BE EXPECTED TO:*

Attend trainingGet the departmental approval form signed and sent to [email protected]. You will find the departmental approval form on this page: https://wellness.okstate.edu/employee-wellness/innovator.html
Click here to go directly to the departmental approval form.
Please submit any questions to [email protected].

We're excited to have you aboard, and thank you!
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AHC New Innovator Application