Sierra Club - John Muir Chapter (Wisconsin): Survey - UW-Madison Sierra Student Coalition

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UW-Madison Sierra Student Coalition

The Sierra Student Coalition is YOUR voice to clean air, clean energy, and clean water solutions on campus. Please fill out the survey below so we can plan events that represent your visions and goals for the SSC.

Please fill in your contact information.

Name:

First Required	Last Required

Email: Required

Street 1:

Street 2:

City/State/ZIP:

City	State	ZIP

Phone Number:

Yes, I would like to receive periodic updates and communications from Sierra Club.

Yes, I would like to receive postal mail from Sierra Club

Question - Required - Can we text you?

Question - Required - Are you interested in attending outing the SSC might participate in? These include things such as snow-shoe trips or canoe trips. (A small fee may be included) Yes
No

Question - Required - Which SSC are you a member of?

Question - Not Required - If so, which outings are of interest to you?
Please make up to 6 selections from the choices below.

	Canoe Trip
	Snowshoe Trip
	Campus Clean-Up
	Tour of a recycling plant
	Participate in Prairie Restoration
	Walks in the Arboretum

Question - Not Required - Other:

Question - Not Required - Which events you like to see the SSC sponsor?
Please make up to 3 selections from the choices below.

	An educational speaker
	Slow Food Night
	Movie Premiere

Question - Not Required - What other educational events would you like to see?

Question - Required - Which programs would you like to see the SSC work on?

	Moving Beyond Coal (such as pushing for stronger regulations on coal)
	Clean Transportation (such as promoting the free bus pass for students program)
	Promoting Energy Efficiency (such as supporting efforts to conserve electricity)
	Water Protection
	Greening Campus (such as supporting recycling efforts on campus)

Question - Not Required - What other programs or campaigns would you like to see the SSC work on?

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Sierra Club John Muir Chapter
222 South Hamilton Street, Suite #1
Madison, WI 53703
(608) 256-0565

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