Skip to content
AHC Innovator Application & Training Registration
Welcome Innovators! Complete the form below to apply for our Innovator Program and register for training.
OK
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
CWID
(Required.)
*
4.
University Email Address
(Required.)
*
5.
Office Phone Number
(Required.)
*
6.
Office/Campus Mailing Address
(Required.)
*
7.
Department
(Required.)
*
8.
Campus Location
(Required.)
OSU-CHS Tulsa
OSU-CHS Tahlequah
*
9.
What interests you about the AHC Wellness Innovator Program?
(Required.)
*
10.
Department Approval Form
(Required.)
Upload a copy of your Department Approval Form. (You can find the form at medicine.okstate.edu/wellness/employee-wellness/wellness-innovators.)
Choose File
No file chosen
Current Progress,
0 of 13 answered
