Request edit access
Climate Conversations by Mviringo Africa
Climate Conversations, part of Mviringo Africa, aims to make learning about and acting on climate change interactive and judgment-free. We're creating a toolkit covering causes, effects and solutions of climate change.

Your input on this Google Form will help us build a powerful resource for advancing knowledge and advocating for climate action.
Name *
Age *
Email *
Phone Number
What is your current status? (Are you  a student or are you working?)
*
CONSENT: The information we collect through this Google Form will solely be used to inform the design and implementation of the Climate Conversations. Your consent to the use of the information you provide to us through this form can be withdrawn at any time. For more information about this project or additional concerns, reach out to us: info@mviringoafrica.org

Please express your consent below to the use of your information in the manner described above.
 *
Required
How conversant are you with climate change on a scale of -1-5? (5 being the most conversant and 1 being the least conversant) *
Below is a list of climate change causes, as identified by the United Nations. Please check all the causes you are aware of that contribute to climate change. *
Required
Below is a list of the effects of climate change as identified by the United Nations. Please check all the effects of climate change that you are aware of.
 *
Required
The climate crisis cannot be addressed in isolation due to its global nature and far-reaching effects. Below is a list of interconnected themes related to climate change. Please tick the themes you are most familiar with. *
Required
Climate Conversations is a project by Mviringo Africa aimed at creating a judgment-free space for people to learn about and take action on climate change. To successfully implement this initiative, we need your input, consent and most notably, your enthusiasm to learn. Are you interested in building/enhancing your knowledge on climate change? *
Required
What is your end goal with building/enhancing your knowledge on climate change?  *
Required
This project is expected to take one to six months, depending on the final design. Are you willing to dedicate the necessary time to build and enhance your knowledge of climate change? (More details will be shared upon confirmation of interest in the program) *
Required
Having filled the form up to this stage, we would like to contact you once the project is ready for delivery. Please indicate your consent to contact you via email and telephone number. *
Thank you for completing our Google Form and taking a step towards creating a safe space where we can  learn and enhance our knowledge about climate change. We will keep in touch in the coming weeks!
For any questions, please reach out to us via email: info@mviringoafrica.org
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms