E²SHI Associates Participation Form Contact Information Highest Degree Earned Name 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. Focus Are you a: Researcher Instructor (Education) Both Research/Education Priorities and Areas of Expertise Research/Education Priorities Briefly describe your research/education connection and disciplinary expertise in one or more of the E²SHI related fields (environment, energy, sustainability or health): What research/education in collaboration with other disciplines would you like to do if funding was available? Researchers: 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/Education 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 Resource Management Civil Engineering Environmental Law Risk Analysis 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/Education 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