CAG - Application Form

Groundwork and Green Umbrella seek highly motivated residents to participate in a Community Advisory Group (CAG). The CAG is a PAID focus group that will create a neighborhood climate action plan for your local community, addressing issues like flooding, heat, and air pollution; understanding how the neighborhood’s history resulted in increased climate vulnerability; and influencing the local government’s processes to better support neighborhood plans. 

This application form is designed to gather information about your background, experiences, and motivations for participating. Your responses will help us ensure a diverse and qualified group of advisors who can contribute to our climate resilience and environmental justice efforts. Please Note: No experience is needed to participate in the CAG.

CAG members must be willing to meet (in person) for two hours a week for five weeks. Members must be at least 14 years old to participate.

If you have questions, contact Sydney :: srosenthal@groundworkorv.org // 513-301-0310 - CSN Coordinator at Groundwork Ohio River Valley.


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PERSONAL INFORMATION
First Name *
Last Name *
Age *
Gender *
Race/Ethnicity *
Please select all that apply
Required
Email Address *
Phone Number *
Street Address *
City *
Zip code *
State *
What neighborhood do you live in? *
How many years have you been a resident in your neighborhood? *
If you are new to the neighborhood and have been there 6 months or less, enter "0". If you have been there 6-12 months, enter "1".
How did you hear about the Climate Advisory Group? *
EDUCATIONAL & PROFESSIONAL BACKGROUND
Educational Background *
What was/is your field of study? *
Current Occupation
Job Title: *
Organization/Employer *
Years in Current Role *
Relevant Experience *
Please describe your background and any relevant experience related to climate resilience, environmental justice, or community engagement. Please note that experience is not required
MOTIVATION & OBJECTIVES
Why are you interested in joining the Climate Advisory Group? *
What specific skills or expertise do you bring to the group?
 *
Please select all that apply
Required
What do you hope to achieve as a member of the Climate Advisory Group? *
COMMUNITY INVOLVEMENT & ADVOCACY
Describe any past involvement in community or environmental projects:
 *
How have you contributed to climate resilience or environmental justice initiatives in your community?
 *
What are the most pressing climate or environmental issues in your community, and how would you address them as a member of the CAG?
 *
DIVERSITY & INCLUSION
How do you think your background and experiences contribute to the diversity of the Climate Advisory Group? *
What perspectives or insights do you believe you can offer that are unique to your experiences?
 *
Do you have any special needs or accommodations that we should be aware of?
 *
If Yes, please specify:
ADDITIONAL INFORMATION
Is there any additional information you would like to provide that would help us in our selection process?
THANK YOU
Thank you for completing the application form. Your interest and commitment to climate resilience and environmental justice are greatly appreciated. We will review your application and contact you if we need any further information or to schedule an interview.

We appreciate your patience as we consider all of our applications. We will reply to all applicants but it may take several weeks.
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