Part-Time and Spouse/Domestic Partner Rewards Forms
Thank your for participating in a Kent State University Employee Wellness event! Please fill out this form completely and Wellness will track your attendance at each event. After 10 events completed, you will be entered into a raffle! 
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First and Last Name *
Email *
Part-Time or Spouse/Domestic Partner? *
If Spouse/DP, please identify employees NAME and KSU Banner ID (Part-Time employees please respond with Banner ID only) *
Enter the secret word from your event. *
Submit
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