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4. Team Name
6. Team Leader Name*
8. Email Address*
9. Phone Number
11. Miles Traveled
12. Month*
    -- Select One --April 1stApril 15thMay 1stMay 15thJune 1stJune 15thJuly 1stJuly 15thAugust 1stAugust 15rhSeptember 1stSeptember 15thOctober 1stOctober 15thNone

    Select the date closest to your actual walking period.
13. Miles*
    Only include miles from last reporting.
15. Weight
16. Month*
    -- Select One --AprilMayJuneJulyAugustSeptemberOctoberNone

    Report the monthly totals at end of month.
17. Weight(lbs)*
    Scales are located in various City facilities. Contact the HR Dept.
19. Challenges
20. Monthly challenges*
    -- Select One --MayJuneJulyAugustSeptermberOctoberNone
21. Week*
    -- Select One --12345
22. How many? How far? or How much?*
26. Team Member Name #2
27. Reporting Dates
    -- Select One --4/1 - 4/144/15 - 4/305/1 - 5/145/15 - 5/316/1 - 6/146/14 - 6/307/1 - 7/147/15 - 7/308/1 - 8/148/15 - 8/319/1 - 9/149/15 - 9/3010/1 - 10/14
28. Miles Traveled
30. Weight
31. Weight
32. Month
    -- Select One --AprilMayJuneJulyAugustSeptOct
34. Monthly challenges
    -- Select One --MayJuneJulyAugustSeptOct
35. Week
    -- Select One --12345
36. How many?How far? or How much?
38. Email Address
39. Phone Number
43. Team Member Name #3
44. Miles Traveled
45. Month
    -- Select One --April 1April 15May 1May 15June 1June 15July 1July 15August 1August 15Sept 1Sept 15Oct 1 Oct 15
47. Weight
48. Month
    -- Select One --AprilMayJuneJulyAugustSeptOct
50. Monthly challenges
    -- Select One --MayJuneJulyAugustSeptOct
51. Week
    -- Select One --12345678910
52. How many?How far? or How much?
54. Email Address
55. Phone Number
59. Team Member Name #4
60. Miles Traveled
61. Month
    -- Select One --Jan
63. Weight
64. Month
    -- Select One --JuneJulyAugustSeptemberOctoberNovember
66. Monthly challenges
    -- Select One --JuneJulyAugustSeptemberAugustOctober
67. Week
    -- Select One --12345678910
68. How many? How far? or How much?
70. Email Address
71. Phone Number
75. Team Member Name #5
76. Miles Traveled
77. Month
    -- Select One --June 1stJune 15thJuly 1stJuly 15August 1stAugust 15September 1 stSeptember 15October 1st October 15
79. Weight
80. Month
    -- Select One --JuneJulyAugustSeptemberOctoberNovember
82. Monthly challenges
    -- Select One --JuneJulyAugustSeptemberOctoberNovember
83. Week
    -- Select One --12345678910
84. How many? How far? or How much?
86. Email Address
87. Phone Number
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