Welcome to the Climate Justice survey!

1
Confidentiality

Your participation in this survey is completely voluntary. No personal information will be collected unless you voluntarily offer personal or contact information. Your personal and contact information will be kept separate from your survey response to ensure anonymity.

Once the survey is closed, your contact information will be used for ENRICH communication purposes, subject to your consent. We will only connect your contact information to your areas of interest if you tell us that you would like to keep in touch and get involved in climate initiatives.
2
Full Name* This field is required.Please enter your full name.
First Name
Last Name
3
Address* This field is required.Please enter your home address.
Street Address
Street Address Line 2
City
Province
Postal Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Email* This field is required.Please enter the best email to reach you.
example@example.com
5
Cellular Phone Number* This field is required.Please enter the best cellphone number to reach you.
Please enter a valid phone number.
6
Home Phone NumberPlease enter a home phone number to reach you.
Please enter a valid phone number.
7
Birth YearPlease enter your year of birth.
Date
Year
Month
Day
8
Organization AffiliationPlease enter the type of organization you are affiliated with. (Where applicable).
Please Select
Please Select
Unions
Community organizations
Environmental organizations
Government
Education
Other
9
Do you self-identify as Black and/or person of African descent?* This field is required.
YESNO
10
Are you interested in getting involved in climate preparedness planning?* This field is required.(e.g. how to prepare for extreme weather events)
YESNO
11
Which of the following issues are you interested in?* This field is required.Select all that apply.
Heat stress
Flooding
Water
The health and mental health effects of climate emergencies
Food insecurity
Sustainable housing practices
Public transportation
Green space
Agriculture and farming
Climate justice issues affecting seniors
12
Are you interested in getting involved in initiatives related to climate resilience?* This field is required.
YESNO
13
Are you interested in contributing to the development of the new Climate Justice Framework at the City of Hamilton?* This field is required.
YESNO
14
Are you interested in developing relationships with climate policymakers and decision-makers and in participating in conversations on climate policy and decisions related to climate preparedness and resilience?* This field is required.
YESNO
15
Are you interested in collaborating on projects that focus on building knowledge and collective resilience through hands-on workshops?* This field is required.
YESNO
16
With your permission, we would like to contact you by email about future opportunities to get involved with the kinds of climate initiatives described above.* This field is required.
Yes, please keep in touch and let me know about future opportunities to get involved.
No thank you, I do not wish to receive communications at this time.
Should be Empty: