Chapter Renewal Form

EnvironMentors Annual Chapter Renewal Form

Thank you for continuing to be part of EnvironMentors. Existing chapters must complete this annual renewal form to confirm their participation for the upcoming program year and provide GCSE with updated chapter, contact, and program information.

Chapter Information

Chapter Name

Organization/Institution Name

Country

State/Province

City

Chapter Lead Information

Current Chapter Lead Full Name

Title/Role

Email Address

Phone Number with Country Code

Is this person still serving as the Chapter Lead for the upcoming program year?

Yes

If no, who will serve as the new Chapter Lead?

Full Name

Title/Role

Email Address

Phone Number

Chapter Information Update

Please describe any significant changes to your chapter.

Upcoming Program Year

Approximately how many students do you anticipate participating in your chapter this year?

Approximately how many mentors do you anticipate participating in your chapter this year?

Do you currently have mentors identified for the upcoming program year?

Yes

We are currently recruiting

Do you currently have students identified for the upcoming program year?

Yes

We are currently recruiting

How will your chapter operate this year?

In person

Virtually

Hybrid

Chapter Experience & Support

What worked well for your chapter during the previous program year?

What challenges did your chapter experience during the previous program year?

What support would you like from the GCSE EnvironMentors team during the upcoming program year?

Is there anything the EnvironMentors team should know as we plan for the upcoming program year?

Annual Chapter Lead Agreement

Please read the detailed expectations of a chapter lead

Serve as the primary liaison between GCSE and chapter.
Attend required EnvironMentors Chapter Lead meetings.
Oversee implementation of the EnvironMentors program within chapter.
Support the recruitment and coordination of students and mentors.
Facilitate successful mentor-mentee relationships.
Communicate program requirements, deadlines, and opportunities to chapter participants.
Ensure required chapter information and reports are submitted to GCSE.
Support students in completing their research projects and participating in EnvironMentors activities.
Uphold EnvironMentors academic integrity, safety, and professional conduct policies.
Failure to meet program responsibilities may affect chapter's participation and student opportunities.

Final Agreement

Annual Chapter Renewal Agreement

I confirm that our organization intends to continue participating as an EnvironMentors chapter for the upcoming program year.

I understand that our Chapter Lead is responsible for coordinating the chapter, communicating with GCSE, attending required meetings, and supporting students and mentors throughout the program year.

I confirm that our chapter will continue to follow EnvironMentors program expectations and policies for the upcoming program year.

Photo & Video Consent

I give GCSE permission to photograph and/or record me during EnvironMentors and GCSE events and activities and to use these materials for program communications, websites, social media, reports, and promotional purposes.

GCSE Newsletter

I would like to receive the GCSE newsletter and occasional updates about GCSE programs, events, and opportunities.

Chapter Lead Name

Date

Month

Day

Year

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