Climate Ambassador Registration

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Thank you for your interest in becoming a Climate Ambassador! This form should take 5-10 minutes. We will collect some basic information about you and your interest in the climate ambassadors program so that we can best serve you as you participate in this series of gatherings. We ask for your town, age, and community affiliations in an effort to recruit ambassadors that reflect the diverse communities on or near Vinalhaven and North Haven.

Feel free to elaborate as much or as little as you'd like in this registration form -- most questions are optional.

Any questions? Email brianna@aclimatetothrive.org (ACTT), COxford@islandinstitute.org for North Haven participants, or gabe@rcmaine.org for Vinalhaven participants.

Email *

Name

How would you like to be contacted regarding the program?

Phone

Either

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OPTIONAL: What's your phone number?

What town do you live in?

Are you a year-round resident of the area? Note: This program is open to both year-round and seasonal residents, we just ask to get a better sense of who is in the room.

Yes

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What is your occupation and/or workplace? Feel free to also state your field more generally, if you're more comfortable doing so.

What community organizations, if any, are you active in in?

Do you hold any leadership positions in your communities?

What age group are you in?

16-22

22-30

30-40

40-55

55-65

65+

Prefer not to say

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Are you able to commit to participating in five weekly meetings with some minimal outside preparation time?

NOTE: These meetings will be over Zoom, except for 1 or 2 potential in-person gatherings. We understand that, of course, sometimes life happens and disruptions come up, and you may have to miss our meeting. Feel free to express any extenuating circumstances or worries you may have here!

Free food will be provided at any in-person meetings (we hope to host 1 or 2 optional in-person gatherings). Do you have any dietary restrictions?

How would you rate your current understanding of climate change on a scale of 1-10 (With 1 being no knowledge at all and 10 being expert knowledge)?

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How would you rate your current level of confidence communicating climate change? (With 1 being severely uncomfortable and 10 being totally confident)

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What makes you interested in joining a community of Climate Ambassadors?

What knowledge and/or skills are you most interested in gaining through this program?

Do you have any other comments?

Would the use of provided childcare make it easier for you to participate in this program?

Yes

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Send me a copy of my responses.

Submit

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