CNRx Active Member Application
Welcome, and thank you for your interest in joining the Campus Nature Rx network!

CNRx Active Membership is free and open to representatives at institutions that manage established, active outreach, teaching, and/or research aimed at supporting campus health and well-being. Active members design and run their own programs. To apply to be a CNRx Active Member, first complete the Membership Form, then this application. We will be in contact once we have reviewed your submission.

Please be sure the information you submit to this form is essentially permanent, as the CNRx member pages are rarely updated. You are encouraged to keep your description more general and include a url for a website you regularly maintain. You will be asked to share a contact name and email address for a program leader that has an ongoing appointment at your institution. This will be posted on the website for visitors who wish to contact you directly about your specific program.

Email us at campusnaturerx@gmail.com with questions, and please inform us if your program is ever discontinued, and/or if there are any major updates so we can keep our website and membership list up-to-date. Thank you for all you do!

-- CNRx Team
Email *
Program contact name(s) (ongoing faculty and/or staff) *
Email address(es) *
How can the program lead(s) be contacted? This will be posted to the public website.
Affiliation *
Location of institution (e.g. Williamsburg, VA) *
Program title *
Program: Goals/mission/purpose *
Program: Audience *
Who is the target audience for your program offerings?
Program: Offerings
What are the primary offerings of your program (If some/all program offerings change frequently please instead direct people to a url for more information and keep your description more general)
Program: Partners
If applicable, might include collaborating departments and/or units at your institution, community partners, etc.
Program: Additional description
If applicable
Program status *
Year founded (if beyond planning phase) *
A web url for your program (if applicable)
Please 2-5 images to a folder for your institution here: tinyurl.com/CNRxImages *
Please be sure to upload images at the same time you complete this form as we may not be able to add them at a later date given the limited resources we have to maintain this website at this time.
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