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Gold Application

Important Notes The activities described in your application should have taken place within the last 12 months.

Activities may be repeated for up to two (2) topics/requirements only.

Policies may be used for multiple topics/requirements.

Please do not submit any private or identifying information such as photos or names of employees who participated in activities, without proof of their consent (it may therefore be necessary to redact some of the information contained in evidence)

You can save and continue your application by clicking on the Save & Continue button at the bottom of the form. You will receive a link that is valid FOR 30 DAYS ONLY. Please enter your email to have the link sent to you – we cannot retrieve any partial entries on your behalf.

BUSINESS INFORMATION

Business Name(Required)

Address(Required)

Contact Person(Required)

Healthy Workplace Information

2. Based on your wellness topic, provide evidence of the following health promotion strategies:
Please provide evidence in the form of pictures, screenshots, electronic documents, or other proof for at least ONE activity or measure that was used by your organization the above health promotion strategies:
Accepted file types: pdf, jpg, doc, png, Max. file size: 300 MB.

Please provide evidence in the form of pictures, screenshots, electronic documents, or other proof for at least ONE evidence of evaluation that was used by your organization to commit to wellness:
Accepted file types: pdf, jpg, doc, png, Max. file size: 300 MB.

Provide TWO (2) Formal Supportive Policies
ONE (1) Informal Supportive Policy
ONE (1) Comprehensive Workplace Wellness Policy
Please provide evidence in the form of pictures, screenshots, electronic documents, or other proof for at least ONE evidence of evaluation that was used by your organization to commit to wellness:
Accepted file types: pdf, jpg, doc, png, Max. file size: 300 MB.

ONE (1) statement of employer’s commitment to wellness.
Please provide evidence in the form of pictures, screenshots, electronic documents, or other proof for at least ONE evidence of evaluation that was used by your organization to commit to wellness:
Accepted file types: pdf, jpg, doc, png, Max. file size: 300 MB.
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