Wellness Champion Online Orientation EXIT TICKET
Ready to complete your first Wellness Champion task? Cheers!
Please complete this Exit Ticket by September 6, 2019 (or by the date specified in your communications with Lydia Yamaguchi)
If you navigate back to another webpage of this orientation, make sure you open it in a new tab so that you don't loose your progress on this form.
Responses to this form are private (not viewable by other Wellness Champions).
You will receive an email with a copy of your responses as confirmation that your response was received.
Sign in to Google to save your progress. Learn more
About You
Name *
School Site *
Please confirm which Wellness Champion role(s) you plan to fill this year. *
This is for your role(s) only, not other roles at your school site. Reference this list for what role(s) we think you plan to fill: https://docs.google.com/spreadsheets/d/1Di1DWYAWwWel12WAaDAgRijD9ujm4SDlWJkjuNWoOhM/edit?usp=sharing
Required
Years as a Wellness Champion *
If you are new to the program, write 0. Welcome! If you're not sure, you can write the first year you participated in the program.
Your position at school site *
Example: 1st grade teacher, Para-Educator, Algebra Teacher, Parent Volunteer, etc.
Is your position certificated, classified, or contracted? *
Are you employed by OUSD, a partner agency, or are you a volunteer? *
If you are employed by a partner agency, place indicate which agency under "Other"
If you are an OUSD employee, what is your OUSD employee ID number? *
If you are not an OUSD employee, put 0.    ||    Thank you for resubmitting. This information is important for stipend disbursement.
If you have other leadership roles at your school site, are on other committees, etc. please list them here:
For example: Science Lead, RJ facilitator, ILT, Culture & Climate Team, School Site Council, soccer coach, etc. We know many Wellness Champions are involved in many things!
What are your preferred gender prounouns? (optional)
For example, she/her; they/them; he/him
Is there anything you'd like us to know about you?
This is just to get to know you a little bit! For example: Lydia is from Long Beach, CA and likes to bike to work when possible.
About Your School Site
Do you know of anyone else at your site that is interested in taking on a Wellness Champion role, that hasn't been in contact with us yet? If so, who and which role?
Does your school site have an educational garden space(s)? *
If yes or partly, please briefly describe the garden space(s).
Describe to the best of your ability, and/or provide contact information for someone who would be able to describe.
Does your school site use a school garden for learning/educational purposes? *
If yes or partly, please briefly describe the garden education activities / programs.
Describe to the best of your ability, and/or provide contact information for someone who would be able to describe.
Online Orientation Review
Online Orientation Action 1: Did you fill out the form answering the question "What is your vision for wellness at your school?"? *
Online Orientation: Did you read the "Wellness Policy 101" slide presentation? *
Online Orientation Action 2a: Did you read the OUSD Wellness Policy & Administrative Regulations? *
Online Orientation Action 2b: Please write a 2-4 sentence reflection on the OUSD Wellness Policy & Administrative Regulations. *
What do you think? What is your reaction to the content? Any questions? Connections to your reality or your goals for this year and beyond?
Online Orientation: Did you read the "Wellness Champion Roles & Key Expectations" slide presentation, especially the slides relevant to your role(s)? *
Online Orientation Action 3a: Did you come up with some ideas for first actions as a Wellness Champion this year? *
Online Orientation Action 3b: Have you done any of those actions? Will you soon? Tell us about it!
Online Orientation Action 4: Based on your understanding of the schedule for the year, are there any clear time conflicts (with meetings, events, etc.) that you are aware of now? *
What additional supports and/or resources from the Wellness Program would be helpful to you, based on your understanding of your Wellness Champion role and plans for this year?
Bonus: How many images of bike blenders/smoothie bikes are there in this online orientation??
You can request to borrow a bike blender for your school event! (also if you navigate to another page of this orientation, make sure you open it in a new tab so that you don't loose your progress on this form.)
Online Orientation Feedback
On a scale of 1 to 5, rate how informative this online orientation training was. *
Not informative
Very informative
On a scale of 1 to 5, rate how easy it was to follow along with this online orientation training. *
Hard to follow along
Easy to follow along
Final Questions
Any additional comments or questions?
Related to the program, this orientation, etc.
Thank you!
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