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Please select one: *I am already a trained StrongWomen/StrongPeople Program LeaderI want to become a StrongPeople Program LeaderOther

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When did you become certified as a StrongWomen/StrongPeople Program Leader? *Enter Year

Which StrongPeople Programs are you already certified to lead? *StrongPeople Strong Bodies (Strong Women Health Training Program)StrongPeople Living Well (StrongWomen Healthy Hearts)StrongPeople Strong Hearts (StrongWomen Healthy Hearts Healthy Communities)Change Club (HEART Club)Select as many as apply

Which StrongPeople Programs are you interested in becoming a trained Leader for? *StrongPeople Strong BodiesStrongPeople Living WellStrongPeople Strong HeartsChange ClubNot sureSelect as many as apply

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Are you affiliated with Healthy Texas? *YesNo

Are you affiliated with Oregon State University (OSU)? *YesNo

Are you affiliated with Utah State University? *YesNo

Do you currently or plan in the future to offer StrongPeople Programs through an organization other than your current employer? *YesNoUnsure

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We require that all StrongPeople Programs be offered in non-profit settings/organizations. Please upload a copy of the affiliated organization tax exempt certificate. *

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