APPLICATION FORM
Climate Change Science and Communication Mini-course
Earth to Sky – Alaska
Morris Thompson Cultural and Visitors Center, Fairbanks, AK
October 21st, 2016
All Applicants must
Submit this application on-line at https://www.surveymonkey.com/r/3P75GCJ
or
Scan this signed, completed form and send it as an e-mail attachment to
The selection of participants will be informed by the brief, but thorough responses to the following questions (Note: you will need to use additional space for your response and submit three pages).
(1) Is your site actively addressing climate change or planning to do so in the future? Briefly describe the climate change impacts, and any mitigation efforts underway. (For example, are cultural resources being relocated to prevent damage from increased number and intensity of storms?) Is your site climate friendly?)
(2) Please list specific areas of interest or climate change impacts for which you have particular concerns or questions, especially with respect to cultural and/or natural resources at your site.
(3) Please provide a brief narrative about how this training will enhance your work. What role do you see yourself playing in your site’s existing or planned efforts to communicate about climate change?
(4) Please briefly indicate your level of experience in interpretation, education, or communication, in terms of years of experience and any specialties you may have.
(5) Please check (√) below any audience for whom you plan to prepare a training, product, or service upon course completion.
___ Fellow Communicators: __ interpreters __education specialists __ outreach staff __ public affairs
___ Other Staff at your site (please describe):
___ Partners/Collaborators (please describe):
___ Community Groups (please describe):
___ Public Visitors
___ School Teachers, Grade level _____
___ Students, Grade level_____
___ Other (please describe):
(6) This course is encouraging regional collaboration. Do you have in mind an individual or organization with whom you plan to develop products, programs, etc., about climate change? ____(Y/N). If yes, please list the person and/or organization.
If no, is there an individual or organization with whom you would consider planning to develop products, programs, etc about climate change? ____(Y/N). If yes, please list the person and/or organization.
Note: A collaborator is not required in order to attend this course.
______
Signature of applicant Date
Do you have Supervisory approval to participate in this course?
______
Supervisor’s Signature Date