Climate Connections: TRANSFORMATIONAL RESILIENCE
Thank you for your interest in our upcoming course! It would be great if you could fill out this form to let us know a bit more about yourself and provide some essential info to help us confirm your eligibility for this programme.

Please answer as honestly as possible to support the facilitators in caring for your needs and those of the group. Your answers will be kept strictly confidential within the facilitation team, and deleted after the programme is complete.
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Email *
Name *
Contact Number
Age *
Emergency Contact (Name & Phone Number) *
Do you have any dietary requirements? *
Phone call application?
If it suits you better to talk by phone, let us know here and we’ll give you a call to talk through your application.
Where do you currently live?
(We ask this to get a sense of who is able to access our events and from where)
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Identity Experience
If you are willing, please tell us a little bit more about how/if you identify in terms of gender, sexuality, racialised experience, and/or anything else that feels important for us to know about your identity experience
Additional Support
Do you require any additional support to attend this event (e.g. neurodivergence and/or physical accessibility needs)?
What interests you most about this course?
Attendance *
Please confirm which events you are able to attend by checking the relevant boxes. (As places are limited on this course, we will prioritise applications who can at least commit to attending all in-person events at Pondfield).
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