N. American Rural Community Climate Action Plan Scholarship Form

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Fill out this short form to apply for a Climate Action Plan course scholarship.

First Name *

Last Name *

Email Address *

The town that you live In and the State/Province
*

If you love outside of town, what town do you live outside of?

What is the population of your town?
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Does your town have a website? What is it?
*

Has your community expressed interest in adapting to a changing climate?
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How would you describe your position in your community?
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I am an engaged, interested community member.

I work for a nonprofit organization working with small, rural towns.

I am a town government or council member.

Other. Please describe as part of the answer below.

What do you do? Examples: Farmer, retired, business owner.
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Ex. I am a teacher, but I'm engaged in working with the community too.

Briefly, what would your role be in developing a Climate Action Plan for your community?
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Ex. I will be the facilitator with community members during the process. I will probably do the writing too.

Are you fully prepared to complete this 8-week course and invest 2/3 hours a week?
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Yes

Are you willing to provide a 1 or 2 sentence review/testimonial about your experience in the course?
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Yes

Where did you hear about this scholarship opportunity? From a newsletter or a website? What is the name or the website link? It is probably still on your desktop.

An accurate answer is required for the scholarship.

Can you recommend other sites where we can announce this opportunity?

Ex. I heard about this from a ClimateNews@googlegroups.com email. Or: I heard about this from the Facebook/Linkedin Group 'My Rural America'.

Another good place would be the Climate Change Professionals group on LinkedIn.

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This form was created inside of Center for Sustainable Development.