Representative form — The Climate Consensus

Are you a student or professional Interested in starting a climate consensus chapter?

As a representative, your duties will include participating in regular (virtual) meetings with representatives, planning and facilitating chapter meetings, and coordinating outreach events in your region. There are also opportunities to volunteer as a member of a committee and to provide/receive support for others who are engaged in this work.

Name

First Name

Last Name

Affiliation

Department name (if university)

Your role

Graduate/undergraduate student, faculty member, postdoc, researcher, forecaster, etc.

Faculty representative information (if university)

If you are a graduate or undergraduate student, please identify the name and email address of a faculty member who has agreed to serve as your faculty representative.

Current outreach

Describe your university's, work's, and/or personal climate outreach efforts to date. If you have not yet been involved in such work, that's okay! Simply state this below.

Reason for joining

Explain why you are interested in joining The Climate Consensus and serving as a representative for your institution.

Any other questions or comments?

Please note the following:

Only complete this form for yourself, as someone working or studying in the sciences who is interested in serving as a representative. If you know of someone else who might be interested in serving in this role, please ask them to complete the form.
For graduate or undergraduate student representatives, please identify a faculty member within your department who is willing to serve as a faculty representative. This person does not need to be actively involved with the group, but will be able to provide department-level support for this work while also serving as a permanent contact for the institution.