Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 5 or Role: Photograph Section 1: Personal InformationName *FirstLastDate of Birth *Date of BirthContact Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryGenderMaleFemaleOtherEmail *Phone / WhatsApp Number: *Preferred Language of CommunicationNextSection 2: Professional BackgroundCurrent Occupation / Role:Organization / InstitutionField of Expertise:Environmental ScienceRenewable EnergyEducation / AdvocacyPolicy & GovernanceTechnology & InnovationAgriculture / ForestryOtherYears of Professional Experience:Educational Qualification(s):NextSection 3: Climate Action Involvement1. Describe your current or previous engagement in environmental or climate-related initiatives: Visual Code 2. What motivates you to serve as a Climate Ambassador?3. Areas of Interest / Focus as an Ambassador (select up to three):Climate Education & AwarenessCommunity EmpowermentClimate Policy AdvocacyResearch & InnovationClean Energy PromotionBiodiversity & ConservationYouth MobilizationClimate Finance and Grants AccessNextSection 4: Commitment & AvailabilityHow many hours per week can you dedicate to Ambassadorial activities?2–5 Hrs6–10 Hrs11–15 Hrs16+ HrsAre you willing to represent the initiative in regional and international events (virtual/in-person)?YesNoDo you agree to uphold the values, ethics, and mission of the UN Climate Action Programe?YesNoDate / TimeDateTimeNextSection 5: Supporting DocumentsCopy of Valid ID / Passport Drag & Drop Files, Choose Files to Upload You can upload up to 3 files. Recent Passport Photograph Drag & Drop Files, Choose Files to Upload Updated CV / Profile Summary Drag & Drop Files, Choose Files to Upload You can upload up to 4 files. Any Certificates or Evidence of Climate-related Work Drag & Drop Files, Choose Files to Upload You can upload up to 8 files. Live Verification Camera * Capture With Your Camera Camera Preview Nomination Number *Updating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit