What's your EX Quit Date?
This information in this form is collected in conjunction with
solely for the purpose celebrating quit milestones of BecomeAnEX members more frequently than yearly. All fields will be required if you choose to participate.
Celebration of your QUIT Date
We're asking for your quit date so that we (The EX Team and the EX community) can help you celebrate milestones. Reaching these dates offers reminders of, and support for, the progress you have made toward becoming a healthier you. In order to assist Mark, the Community Manager in this effort we're asking you to complete this simple form. If your quit date changes, please, come back and update the form. You should also update your quit date on the EX Plan Site (
) as well. Once you edit it, please logout(
) and back in to update your quit date on the EX community.
What is your EX community username?
You can find your community username at
. Look for the value next to Username:.
Please provide a link to your community profile.
Your profile link should look similar to:
When did you quit?
Please don't sign up until you have successfully quit.
Checking your quit date on the EX community
Have milestones recognized?
Yes, I wish to have my Quit milestone celebrations recognized more frequently than yearly.
No, I wish to only have yearly Quit celebrations recognized.
EX Community Manager
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