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* 1. First and Last Name

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* 2. Employee ID #

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* 3. Department

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* 4. Email Address

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* 5. Would you be interested in attending a Weight Watchers at Work meeting at Human Resources & Development? (2500 W. Burrel Ave, Visalia)

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* 6. What time would you be interested in attending for the meeting?

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* 7. What other locations would you be interested in attending a Weight Watchers at Work meeting?

**The start of the Weight Watchers at Work Program will be determined on the amount of interest. You will be notified within a few weeks

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