Chapter Registration Form

Chapter Registration

Complete this form to register a new Youth Climate Institute chapter. Please note that school system email servers often block WordPress emails. Once this form is submitted, you should receive an automatic response from wordpress@youthclimateleader.org. If you do not receive this email, please check your spam or reach out to support@youthclimateleader.org. Note that this form is for adult chapter leaders. Interested students looking to start a chapter should connect with an interested teacher/adult and/or contact us for more information.

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This field is for validation purposes and should be left unchanged.

Chapter Leader Name(Required)

Please list the name of the person who will be acting as chapter leader and communicating with YCI staff. This person should be at least 18 and should follow the policies of their organization when conducting chapter activities.

First Last

Username

Chapter Leader Email(Required)

If your organization's email server tends to block outside emails, please use your personal email address. Otherwise, please check your spam folder for your confirmation email after submitting this form to ensure you can receive our emails.

Secondary Email or Phone

While we will use the email address above as our default method of communication, please list an alternate email address and/or phone number where we can reach you in case our messages are blocked.

Chapter Host Site/School Name(Required)

Please list the name of your site as you'd like it to appear on our chapter list and student application.

Will your chapter have a co-leader?(Required)

Check yes if your chapter will have a second adult chapter leader. While students are encouraged to take on leadership roles in managing the chapter, please only include adult leaders here as they will receive application information about the students in their chapter.

Yes

Co-Leader Name

This person should be at least 18 and should follow the policies of their organization when conducting chapter activities.

First Last

Co-Leader Email

Address(Required)

Please include the address that you would like us to use for our chapter map.

Street Address Address Line 2 City State ZIP Code

What grades will you serve?(Required)

The Youth Climate Institute is a high school certification program. Students may join in any grade in high school. Please list the grades you anticipate serving in your chapter.

Select All

9th Grade

10th Grade

11th Grade

12th Grade

Name of Referring Chapter Leader

If you were referred to YCI from a current chapter leader, please list their name below.

How did you hear about YCI?(Required)

You should receive a confirmation email within 10 minutes of submitting this form. Please also check your spam folder if your confirmation does not appear in your inbox. If no email was received, please reach out to support@youthclimateleader.org.

Chapter Registration

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