APPLY! REQUEST

Wellness Center Access Request

Please fill out the below form:

NOTES:  This is not to request access to the Student Recreation Center.  Access to the Student Recreation Center is granted when a fee is paid.  Please contact the Business Office with questions regarding fees. 

Please request access ONCE.  If a replacement card is given, previous access is automated.

- indicates required field

(12-digits)

Please make sure all required fields have been filled out correctly.
Submission received!