"UMD WELLNESS WALKERS" DAILY LOG FORM

Name   Department  
Campus Ph.   Email  
Date
# of points
Date
# of points
Date
# of points
Date
# of points
9/11
  
10/01
  
11/01
  
12/01
  
9/12
  
10/02
  
11/02
  
12/02
  
9/13
  
10/03
  
11/03
  
12/03
  
9/14
  
10/04
  
11/04
  
12/04
  
9/15
  
10/05
  
11/05
  
12/05
  
9/16
  
10/06
  
11/06
  
12/06
  
9/17
  
10/07
  
11/07
  
12/07
  
9/18
  
10/08
  
11/08
  
12/08
  

9/19

  
10/09
  
11/09
  
12/09
  

9/20

  
10/10
  
11/10
  
12/10
  
9/21
  
10/11
  
11/11
      
9/22
  
10/12
  
11/12
  

My choice of gift is
(check one):            

UMD Wellness
t-shirt (specify size--if size
desired is not available,
the next available size will
be provided)
XL L S

Undated HealthCare-
Toons Desk Calendar

52 Pick Up Healthy
Changes Cards

UMD HR Navy
Blue Mug

2007 Year of Good
Health Wall Calendar

"do" Water Bottle
9/23
  
10/13
  
11/13
  
9/24
  
10/14
  
11/14
  
9/25
  
10/15
  
11/15
  
9/26
  
10/16
  
11/16
  
9/27
  
10/17
  
11/17
  
9/28
  
10/18
  
11/18
  
9/29
  
10/19
  
11/19
  
9/30
  
10/20
  
11/20
  
   
10/21
  
11/21
  
   
10/22
  
11/22
  
   
10/23
  
11/23
  
   
10/24
  
11/24
  
   
10/25
  
11/25
  
   
10/26
  
11/26
  
   
10/27
  
11/27
  
   
10/28
  
11/28
  
   
10/29
  
11/29
  
   
10/30
  
11/30
  
     
10/31

September Total

  
October Total
  

November Total

   December Total  
Grand Total