Nurses Climate Challenge for Sigma Chapters

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This form is for completion by a board member of a *Sigma Chapter to commit to the Nurses Climate Challenge.

*Sigma Theta Tau International Honor Society of Nursing

Email *

Have you read the Sigma Chapter Commitment for the Nurses Climate Challenge linked on the website and would like to sign up your Sigma Chapter? *

Yes

Name of Sigma Chapter *

What is the City, State associated with your Sigma Chapter? *

What is the (approx.) number of members in your Sigma Chapter? *

List your Sigma Chapter’s affiliated School(s) of Nursing / Healthcare Organization(s) (if/as applies)
*

Your First and Last Name and Credentials *

How did you hear about the Nurses Climate Challenge Commitment?
*

Alliance of Nurses for Health Environments

Health Care Without Harm or Practice Greenhealth

Sigma International, Sigma Regional Contact, Sigma Chapter or a Sigma Member

A colleague

A student

Other:

What board position do you hold in your Sigma Chapter? *

Do you plan to partner with your affiliated School(s) of Nursing to integrate climate health content into the curriculum? If yes, please briefly describe these plans
*

Briefly explain your Sigma Chapter’s current approach to educating about the health impacts of climate change.
*

Briefly, describe future plans your Sigma Chapter has for educating or advocating about climate health.
*

Please list social media connections for your Sigma Chapter, if you would like us to promote your participation (Link to your Facebook, LinkedIn, and/or Instagram. If unavailable, type "N/A")

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