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Workplace Campaign Signup
Please fill out the following fields about your company and whether you hosted a workplace campaign previously.
* Indicates required question
Email
*
Record my email address with my response
Company Name
*
Your answer
Mailing Address
*
Your answer
Website Address
Your answer
CEO Name
*
Your answer
Phone Number
*
Your answer
Email Address
Your answer
Number of Employees
Your answer
Number of Locations
Your answer
Employee Campaign Coordinator (ECM) for 2022
*
Your answer
ECM Phone Number
*
Your answer
ECM Email Address
*
Your answer
Would you like a UW staff member or representative to attend a kick-off or other campaign event?
Yes, I'd like an in-person speaker
Yes, I'd like a speaker for a virtual event
No
Other…
Clear selection
Have you decided on campaign dates/approx. timeline for this year?
Your answer
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