Climate Smart Leaders Nomination Form

The Climate Smart Leaders program serves to celebrate and promote individuals and groups that are active in the Climate Smart Challenge. Climate Smart Leaders help to inspire others in the community to join the Challenge and become Climate Smart Leaders themselves.

If you believe that you or someone you know is a Climate Smart Leader please fill out the application below.

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* 1. Name of Individual/Group:

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* 2. Email or Phone number of Individual/Group:

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* 3. Action/Actions Achieved:

Earned at least 5000 points in the Challenge

Participated in the Climate Smart Challenge Teams program

Completed one or more of "the Big Actions” (see below)

Other (please specify)

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* 4. If you selected “Completed one or more of the Big Actions” above, please mark which actions below were completed:

Choose Green Electricity

Install solar panels

Eati lower down the carbon chain

Buy or lease an electric vehicle

Reduce air travel

Offset air travel

Take the bus

Talk about solutions

Take the train or subway

Install electric heat pump water heater

Bike, walk, skateboard, or unicycle

Install electric heat pump heater

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* 5. Please attach a Picture of individual/group or action taken for use in community communications (optional):

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File