Express Interest in Proposed EarthConnections Alliance

Learn more about the EarthConnections Alliance (opens in a new window).

Submitter InformationFirst Name:

Last Name:

Name of Institution or Organization:

Email Address:

Confirm Email Address:

How would you like to become involved?Choose one of the following:

My group plans to submit materials for consideration as a Year 1 regional alliance by March 11.
My group is interested in being considered for a regional alliance in a later year.
My group would like to join the community of practice only.
My group would like to be a program partner.
My group is no longer interested in being involved.

Alliance InformationRegion (geographic area of participants the alliance will include)

What do you know about potential partners, existing programs, and community issues in your region?

Program Partner InformationProgram Name

Please give a two line description of how your program could contribute to strengthening a regional pathway.

My group would like to nominate a consultant corps member.

Other InformationIf there is online information about your program or group, please provide the url(s) here.

Please use this box for any other information you would like to share.

Name Email