Faculty (begin here):

Demographic information:

 # of years serving CSU-Pueblo
 Adjunct
 Instructor
 Assistant
 Associate
 Full

Please select where you serve:

CEEPS	CHASS	CSM	HSB	LIBR	ADMIN

Staff (begin here):

Demographic Information:

 # of years serving CSU-Pueblo
 Classified
 Professional/Administration

Faculty/Staff:

Please take a moment to reflect on your health experience during a typical fall semester. Check the weeks (if any) that you are really run down and/or taking sick days:

	August	September	October	November	December
Week1
Week2
Week3
Week4

For faculty and staff interacting closely with students, please check the weeks (if any) that you find students are typically really run down and/or taking sick days:

	August	September	October	November	December
Week1
Week2
Week3
Week4

Please look over the THREE options provided in the calendar form and choose the option you believe would best serve faculty, students and staff. Then take a moment a provide a reason for your selection.

(no change to existing calendar schedule) Option 1	Option 2	Option 3
Please provide reason for selecting Option 1.	Please provide reason for selecting Option 2.	Please provide reason for selecting Option 3.

Please enter your email address:

Thank you for your responses, we greatly appreciate your help!