JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
The Engineering Wellness Academy
Thank you for your interest in joining the Engineering Wellness Academy (EWA).
Registration opens only twice a year, so make sure to provide your information below to stay up to date on when the next session opens.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Your Name (First & Last Name):
*
Your answer
Best Email Address (make sure to add
lennis@lennisperez.com
into your email contacts to make sure any communication between us doesn't last in SPAM)
*
Your answer
How much time are you willing to commit to your well-being on an "hours per week" basis?
*
< 1 hr
1 - 3 hrs
3 - 6 hrs
> 6 hrs
Other:
Required
Thank you!
Your information has been captured and we will contact you in the upcoming days to confirm your addition to the waitlist.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of lennis perez.
Report Abuse
Forms