E2SHI Associates Participation Form - Environment_ Energy

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					                               Environment, Energy, Sustainability
                               & Health Institute


                         E²SHI Associates Participation Form
                                                       Contact Information

Name                                                                                     Highest Degree Earned
                       First                            Last

Email                                                                                                    Telephone


Title(s)


Department


Joint Appointments
                       If not applicable, enter N/A.

Affiliations
                       List other JHU or non-JHU institutes/programs in which you are involved. If not applicable, enter N/A.

Website
                       Link to your faculty web page, professional website, or other link with your CV, publication listings, etc.



                                 Research Priorities and Areas of Expertise
 Research Priorities

  Briefly describe your research connection and disciplinary expertise in one or more of the E²SHI related fields
  (environment, energy, sustainability or health):




  What research in collaboration with other disciplines would you like to do if funding was available?




  What audiences would you find value in working with? For example, to disseminate research findings or implement a
  model/strategy based on research findings. Enter X in all audiences that apply.

                 Consultants                                       Industry / Businesses

                 Government Agencies                               International Agencies

                 Government (legislative branch)                   Nongovernmental / Nonprofit Organizations

                 Health Practitioners                              Think tanks (organizations that translate research to policy)
 Research Areas and Expertise Enter X in all research areas that apply
 If a specific area is not listed or needs further clarification, list additional items in the “Other Research Areas and Information”
 section.

        Agriculture and Food                         Energy, Electricity                            International Health

        Air Pollution                                Energy, Fossil Fuel                            International Policy

        Behavior Change                              Energy, Nuclear                                Mechanical Engineering

        Bioethics                                    Energy, Renewable                              Nanotechnology

        Bioinformatics                               Energy Policy                                  Population Studies

        Buildings                                    Environmental Education                        Production & Manufacturing

        Cities and Built Environment                 Environmental Health                           Renewable Energy

        Civil Engineering                            Environmental Law                              Resource Management

        Climate Change                               Environmental Management                       Rural Development / Economies

        Community Development                        Environmental Policy                           Social Entrepreneurship

        Computer Engineering                         Environmental Sciences                         Solid Waste

        Corporate Social Responsibility              Epidemiology                                   Sustainable Development

        Developing Countries                         Foreign Policy                                 Systems Engineering

        Ecology                                      Globalization and Trade                        Transportation

        Economic Development                         Governance and Participation                   Urban Planning

        Ecosystem Management                         Health, Behavior and Society                   Waste and Resource Use

        Electrical Engineering                       Health Policy                                  Water

        Energy Efficiency & Use                      Human Interaction                              Wildlife Conservation
        Engineering                                  Immigration/Migration                          Other (complete section below)



Other Research Areas and Information




                                                              Referrals
 If you have colleagues you would like to recommend as an E²SHI Associate, please share their contact information.


Name                                                                  Name
Department                                                            Department
Telephone                                                             Telephone
Email                                                                 Email




                                 Email completed form and a copy of your resume/CV to
                                      E²SHI Program Coordinator at kilima@jhu.edu

				
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