Step Into Spring 2023 Registration Form

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What is your name?

(Last name, First name)

What is your T Number? *

What is your preferred email address? *

What is your primary status? *

Student

Faculty

Staff

Fitness Center Member

Other:

How do you identify?

Female

Male

Non-binary

Prefer not to answer

Where do you live?

On-campus housing

Little Rock metropolitan area

In Arkansas, outside of the Little Rock metropolitan area

Outside of Arkansas

Clear selection

If you are UA-Little Rock faculty or staff, what is your office address?

What is your t-shirt size (T-shirts are not a part of the program, there may be a limited number available for prize drawings.) *

XXL

XXXL

Privacy notice:

Individual private information received during this program will not be shared with anyone outside of the Counseling Services and Fit/Well Offices. The only information used in any reporting will be numbers regarding numbers of participants, demographics, ratios, and trend numbers.

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