CLIMATE ACTION PLAN - City of Urbana

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APPENDIX D: PUBLIC INPUT FORMS
2010:
Submit by Email
Print Form
Urbana Climate Action Plan
Public Input Form
The City of Urbana Sustainability Advisory Commission is soliciting input from various stakeholders on the
Urbana Climate Action Plan, a community-wide plan to reduce greenhouse gas emissions. The Commission
is preparing a Climate Action Plan recommendation to be presented to the Urbana City Council for review
and implementation. Your responses to the following questions will be used to guide the direction of the
Climate Action Plan as it is developed. We look forward to your involvement. Please feel free to contact us
with questions or comments. Thank you.
1. Your Name (optional):__________________________________________
2. Are you a resident of Urbana ____Yes ____No
3. Where do you live ____________________________________________
4. Do you own property in Urbana ____Yes ____No
5. Do you own or manage a business in Urbana ____Yes ____No
If so, please select the sectors that best describes your business.
____Industrial ____Commercial ____Transportation ____Waste ____Residential
6. Are you involved with any local non-profit organizations or community groups __ Yes __No
If so, please list them: ______________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
7. Check the box below that best describes the extent to which your primary business, non-profit
organization, or community group has considered its energy use or greenhouse gas emissions:
Has not considered
Identified some greenhouse gas emission sources or energy-saving measures
In process of a project to reduce energy use or greenhouse gas emissions
Successfully implemented a project to reduce energy use or greenhouse gas emissions
8. Check the box below that best describes the extent to which you have considered your personal
energy use and greenhouse gas emissions:
Have not considered
Identified some greenhouse gas emission sources or energy-saving measures
In process of a project to reduce energy use or greenhouse gas emissions
Successfully implemented a project to reduce energy use or greenhouse gas emissions
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