Climate Champions Application-Individuals

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When we created the Dane County Climate Champions our aim was to recognize businesses, local governments and nonprofits that are leading on climate change.

Reality is, though, individuals are leading too--in a variety of ways.

Fill out this form to get a Climate Champions decal for your own efforts. And then use the decal to encourage others to act as well!

Email *

First name *

Last name *

Mailing address (include city and zip code, please) so that we can send you a decal.

Which of the following actions have you taken to earn the Climate Champion status as an individual or household? *

Energy efficient home - use at least 25% less energy than typical home

Water efficient home - use at least 25% less water than typical home

Zero waste at home

Solar energy system on house that provides at least 1/4 of the electricity used

All - electric home

No car - use transit, bike, walking instead

Plug-in hybrid vehicle

Battery electric vehicle

Compressed Natural Gas vehicle

Biodiesel vehicle

Gas or diesel vehicle that gets at least 45 mpg

Plant-based diet

Other:

Required

Do you prefer a window decal, a vehicle decal or both?

Window decal (sticks to inside or outside of a window)

Vehicle decal (adheres to hard surfaces like car bumpers)

I don't want a decal

Both options please

Please share one of the benefits you see from your action; we may use your insights (without your name) in our communications promoting these kinds of actions. *

What else should we know about your efforts? *

A copy of your responses will be emailed to the address you provided.

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