Report Miles
First Name
Last Name
Email Address
Select the reporting week
(weeks begin on Sunday)
01/10/10
01/17/10
01/24/10
01/31/10
02/07/10
02/14/10
02/21/10
02/28/10
03/07/10
03/14/10
03/21/10
03/28/10
Reporting Distance:
You may report mileage, # of steps, or amount of time in minutes that you exercised.
Choose only
ONE method
to report distance.
Steps or exercise time will be converted to mileage for you.
Choose your method of measurement by entering the TOTAL in that box for the WEEK you selected above:
Miles
Steps
Exercise Time
enter in minutes
When your form is complete, click on this button
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