New NHACC Member Form

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Thank you for your interest in joining NHACC - we are so excited to have you! If you have any questions, comments or concerns, please email nhaccleadership@gmail.com.

Name *

Email Address *

Phone Number *

School Program (Name of School and MHA, MHSA, MPH, etc.) *

Year in Program *

1st Year

2nd Year

Other:

Why are you passionate about the environment and in joining NHACC? *

How does climate change relate to your current role and future career? *

Are you involved in any additional climate organizations? *

What are your goals for your involvement in NHACC? *

Please list any questions, comments or concerns.

Please send a headshot of yourself to nhaccleadership@gmail.com. We would like to have these photos a bit more casual than regular headshots. For example, photos of yourselves outside in a casual outfit would work. Please make sure the photo has good lighting and is not out of focus. *

Okay!

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