$120 Award

Congratulations on completing the 2021-2022 WCPS Employee Wellness Program, WellAware! You are eligible to redeem your wellness incentive, valued up to $120. Please fill out the form below.

Note: Reimbursements will be accepted for wellness-related items purchased between May 1, 2021 - April 30, 2022. You can be reimbursed for multiple items, up to a total value of $120. To be reimbursed for multiple items, complete the form below for each item submission and include your proof of purchase. Only one reimbursement may be submitted at a time. A reimbursement will not be awarded without a valid receipt.

Personal Details

First Name

Please enter your first name.

Last Name

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Date of Birth

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WCPS Email Address

Please enter your WCPS email address.

Address

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City

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State

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Zip Code

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My Incentive

Incentive

Please select the incentive.

Reimbursement Purchase Description

Reimbursement Date of Purchase

Reimbursement Upload (receipt/proof of purchase – note: one receipt per submission)