CHanGE Membership Application
Thank you for your interest in being a member of the Center for Health and the Global Environment (CHanGE)!  As a member you will be part of an exciting community of faculty, students, and others working together to advance climate and health scholarship, develop and implement practical solutions, and highlight effective policies for protecting health.

To become a member, please answer the questions below about your background and interests. We will include this information on our website and member directory and use it to inform our planning so we can support you most effectively.
Email *
First Name *
Last Name *
What best describes your current status? *
Do you have a web page that describes you or a departmental bio that we can link to? If so, please provide the link here.
What is your primary department?
What are your primary areas of interest? *
Recognizing the overlap between these different areas, how would you rank your priorities in the area of climate and health?   *
First priority
Second priority
Third priority
Research and scholarship
Policy and decision support
Teaching and practice
Does your work have a particular geographic focus? Check all that apply. *
Required
Does your work focus on areas with a particular level of development? Check all that apply. *
Required
Do you have expertise in climate and health? If not, please skip. If so, please rank your expertise the following major climate and health topical areas.
Low
Medium
High
Mitigation and its health benefits
Adaptation
Risk assessment
Agriculture, food systems, and nutrition
Water- and food-borne disease
Injuries
Heat
Maternal and child health
Air pollution
Mental health
Toxicology
Extreme events and disasters
Mass population movements
Built Environment, land use, nature and health
Clear selection
Are you interested in being a part of climate and health research activities? If so, please tell us what broad categories of research you are interested in. Please check all that apply. *
Required
Are you interested in teaching and/or mentoring related to climate change and health? If so, please tell us the broad categories of teaching you are interested in. Please check all that apply. *
Required
What types of support from CHanGE are you particularly interested in? Please check all that apply. *
Required
Thanks for becoming a CHanGE Member!
We will be in touch with additional material shortly. In the meantime, please reach out to us at chge@uw.edu with any questions or concerns.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of UW. Report Abuse