Wellness Champion: Application and Statement of Commitment

As an Ontario Tech University Wellness Champion your role is important in supporting the well-being of staff and faculty and ensuring two-way communication between your department/faculty and the Wellness at Work team.

Please complete this application and statement of commitment to apply to be a Wellness Champion.*
*We are seeking at least one Wellness Champion per department/faculty.

Application:

Your Full Name
Your Ontario Tech email ending in ontariotechu.ca
Your Department/Faculty
Share why you would like to join the Wellness Champion network at Ontario Tech University.
Statement of Commitment:
Wellness Champions commit to the following:
1. Your Responsibilities:
• I will review the monthly Wellness at Work Update Poster and share the information with my department/faculty on a monthly basis, according to our regular information sharing channels such as team meeting, faculty council, etc. • If my department/faculty utilizes a bulletin board to post notices, I will arrange for the Update Poster to be printed and posted. • If I receive feedback from my department/faculty, I will share this information with the Wellness at Work team by emailing wellnessatwork@ontariotechu.ca within a timely manner of receiving the feedback. • I will provide a photo and bio to be posted on the Wellness Champions webpage (restricted to Ontario Tech). • I attend an orientation session and semi-annual check-ins. • I will notify the Wellness at Work team if I will be away for an extended period of time, and I will be unavailable to share monthly updates with my department/faculty. • I will notify the Wellness at Work team if i am unable to fulfill my Wellness Champion responsibilities, if I am unable to fulfill a 2-year term, and/or I require support for my own well-being.
2. Scope of Practice:
• During this role, if a situation goes beyond my training/knowledge I will seek/refer to the appropriate supports and resources. • I acknowledge that the Wellness Champion role is voluntary and taking on this role will not impact my professional obligations.
Manager's email:
Please check to acknowledge that your manager is aware and supports you in volunteering to become a Wellness Champion.

Please check to acknowledge that your manager is aware and supports you in volunteering to become a Wellness Champion. Yes, my manager is aware.
Acknowledgement:
I, (please insert your full name in the textbox below), have read the above Statement of Commitment and agree to abide by this commitment.
Date Date / MM / DD YYYY
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Full Name

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Wellness Champion: Application and Statement of Commitment

Wellness Champion: Application and Statement of Commitment

Acknowledgement: