Employee Wellness Committee - Incentive Program
Optional Point Sheet
Employee_______________________________________ Building_______________________________________
Optional Point Sheet must be turned in to your building MBS representative to receive a punch on your punch
card. A point sheet can be turned in 4 times during the school year in place of a Wellness event (events listed
on your punch card). You must earn a minimum of 154 points for the point sheet to qualify for a punch.
Activity
Week 1
Physical Activity – includes cardio
& strength training
15 min. = 1 point
30 min. = 2 points
45 min. = 3 points
60 min. = 4 points
Max. of 20 pts. per week.
Nutrition – get the recommended
daily amount of fruits and
vegetables per day
(5-6 servings per day = 1 point)
Get the recommended daily
amount of water per day
(min. six 8oz glasses per day = 1 pt.)
Stress Release Activity
“Me” time: reading, meditation,
stretching, hobbies (5 points each
time; max. 20 points per week)
Extra Points to Earn
Health Screenings
10 points per screening
(cholesterol, colonoscopy, prostate,
mammogram, eye exam, dental, etc.)
Organized Sports or events
Leagues, walks, runs, etc.
10 points for a one-time event; 20
points for league participation
Grand Total Points
Points Per Week
Week 2
Week 3
Week 4
Monthly
Totals