Radiation Monitoring Project October 2018 Training Application Form
The Radiation Monitoring Project (RMP) aims to put radiation monitors into the hands of communities affected by ionizing radiation and to provide professional training to monitor, document, and understand how radioactive pollution impacts front-line communities. We invite you to participate in this project. Our next training will be in Flagstaff, AZ & its vicinity on October 27 & 28, 2018.

This two-day professional training will empower participants to accurately collect radiation readings in their areas. We are accepting a limited number of applications with priority given to POC Frontline community members - please fill out this form to tell us about radiation issues in your community.

Application deadline is Tuesday July 31, 2018.

Radiation Monitoring Project

Contact us:
505-879-8547
radmonitoringproject@gmail.com

To submit via mail :
RMP
227 E. 7th Street Apt 7G
Brooklyn, NY 11218

The RMP is a collaboration of: Diné No Nukes, Nuclear Energy Information Service, & Sloths Against Nuclear State.
http://radmonitoring.org

PART 1: Your Contact Info
Your name *
Your answer
Organization name (if any)
Your answer
Email address *
Your answer
Phone number *
Your answer
Mailing address
Street Address, Apt #, City, State, Zipcode
Your answer
What is the best way to contact you? *
PART 2: About Radiation in Your Community
1. Can you tell us about radiation problem(s) in your community that you are aware of? *
Your answer
2. Are you or others actively working on this issue? *
--- If yes, what kind of work is being done?
Your answer
3. Can you tell us how you would like to use the monitoring device? (Where? How often? etc.) *
Your answer
4. Can you tell us how you would like to use the data you collect?
Your answer
PART 3: About the Training
5. We strongly recommend everyone to take the entire training (Oct 27-28). Can you attend the two-day training in full? If not, please indicate which day you can.
6. At the end of the training, you can receive a monitoring device for your community monitoring. RMP will lend one for a limited period of time, but you also have an option to purchase one. Would you like a monitoring device? *
7. Will you need travel assistance to attend the training? *
Required
8. Will you need a lodging? If yes, we will try and arrange a room for you in Flagstaff (we have a limited number of lodging available).
PART 5: Anything Else?
9. Please share any questions and comments that you may have.
Your answer
10. How did you hear about RMP?
Your answer
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