Community Survey

Cool Petaluma Action Tracker
Your actions matter.

Can you spare 5 minutes to report your actions and help us track Petaluma's acheivements?

Your feedback will be used to inspire others and support our mission of climate action through community building.

Your Name

First NameLast Name
Your Age Bracket
This helps us get funding :)
Your Zip Code

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Email
example@example.com
Which best describes your living situation?

Other

Which best describes your relation to the program?

Cool Team Tracker
As a team member, have you hosted any gatherings for your group?
What aspects of the program did you find inspiring or valuable?
Were there any challenges you encountered?
Any comments on your experience with the program?

Household Action Tracker
For each section, please provide your best estimate on the number of actions you or your household have taken since hearing about Cool Petaluma. Actions can be big or small. :)

For examples or inspiration, check out coolpetaluma.org/action
Build Community

How many actions has your household taken to...
Know your neighborhood
Gotten to know 6 neighbors, hosted a block party, shared resources with neighbors, etc.
Get involved in Petaluma
Joined a local organization, participated in city government, volunteered, etc.
Prepare for Emergencies

How many actions has your household taken to...
Plan for communication
Started a personal emergency plan, learned where to get information and alerts, made a contact plan, etc.
Secure your home
Gathered supplies, prepared for utility interruptions, hardened your home (earthquakes, weather, fire), etc.
Prepare for an evacuation
Know what to take, know where to go, be ready to leave (go bag, evac plan), etc.
Rethink Consumption

How many actions has your household taken to...
Eat wisely
Reduced food waste, picked healthier foods for the planet, avoided packaging, etc.
Share more & shop smartly
Dress wisely, rethink home goods, reimagine gifts, etc.
Vote with your dollar
Supported good company practices, divested from fossil fuels, invested in offsets, etc.
Transform Transportation

How many actions has your household taken to...
Find alternatives to car travel
Walked more, biked more, used public transportation, etc.
Reduce distances traveled
Reduced auto mileage, vacationed nearby, reduced flights, etc.
Electrify your transportation
Gotten an EV, used an ebike, installed a charger, etc.
Improve Buildings

How many actions has your household taken to...
Reduce power & water needs
Conserved water indoors, reduced power load, improved building efficiency performance, etc.
Electrify the home/workplace
Water and space heating, large appliances, other equipment, etc.
Use sustainable resources
Chose cleaner energy, reused water, conserved materials, etc.
Restore Nature

How many actions has your household taken to...
Protect & grow local habitat
Grown a garden, saved water outside, supported wildlife, etc.
Restore our watersheds
Worked to protect watersheds from toxins, use plastic responsibly, protect fisheries, etc.
Restore land ecosystems
Worked to protect forests, return to natural systems, bought recycled paper products (like TP), etc.
OPTIONAL- Put your actions on the map!

Inspire your neighbors! Share with us your address to be placed on our action tracker map. (Identifying information will not be published)
Street Address

Street Address Line 2

CityState

Zip Code
Your reported actions: :)
Should be Empty:

Cool Petaluma Action Tracker

Cool Team Tracker

Cool Team Tracker

Household Action Tracker

Build Community

Prepare for Emergencies

Rethink Consumption

Transform Transportation

Improve Buildings

Restore Nature

OPTIONAL- Put your actions on the map!