EPN Survey Please remember to click/tap “Submit” to ensure your changes are saved. What's your first name?* What's your last name?* Home Phone number Work Phone number Cell Phone number Email address* City Zip Code* Congressional district You can find your congressional district using this website: www.house.gov/representatives/find-your-representative When you have found your district, please enter the district code, e.g. PA-5 About You Have you worked at EPA?* Yes No If you have worked in an EPA Regional office, laboratory, or other office outside of Washington DC, please identify the office/lab. You can check more than one Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region 10 Other: What years did you work for EPA? Enter two years, e.g. 1985-2016, please include earliest and most recent dates, even if you took time-off in-between. Dates MUST be between 1970 and 2020. Start Year, From: End Year, To: If you have worked in a Federal agency aside from EPA, please identify the agency. If you have worked in a state, local, or tribal agency, please identify the state, locality, or tribe. If you have worked as a consultant to any of the above agencies, please identify the firm. Please list your most relevant job title(s), office/divisions, and locations (and organizations if not EPA). For example, Manager, Planning Office, Air Division, Region 9. You can list more than one. * Your ExpertisePlease check any/all of the areas where you have programmatic and/or statutory area(s) of expertise You can check more than one EPA Budget Air Quality: General Air Quality: Mobile Source Air Quality: Stationery Source Air Quality: Climate Change Air Quality: Radiation/Indoor Air Water Quality: General Water Quality: WOTUS Water Quality: Point Source Water Quality: Non-point source Wetlands/Coastal Issues Water Infrastructure Drinking Water (SDWA) Superfund/Brownfields (CERCLA) Solid/Hazardous Waste (RCRA, SWDA) Toxics (TSCA) Pesticides (FIFRA) Energy Issues Research (HQ) Research (Lab) Sustainability/Planning Enforcement/Compliance NEPA EPCRA (Community Right-to-Know Act) Environmental Justice/Civil Rights Children’s Health Ethics / Conflict of Interest Grant Programs (multi-statute) State and Tribal Programs (multi-statute) Information/Outreach/EPA Website Regulatory Flexibility Act and/or SBREFA Congressional Review Act Regulatory Reform and Associated EO's Freedom of Information Act Federal Advisory Committee Act EPA Regional Office Operations Human resources/staffing Contracts IT Please let us know if you have expertise in the following fields: You can check more than one Economics Law Science Government Affairs/Congress Public Affairs/Communications If you have expertise with specific advisory groups (SAB, CASAC, NEJAC, CHPAC, etc.), please identify them. Other Areas (please specify; for example: International, Appeals Board, Education, Inspector General, Homeland Security, Small Business, Administrator’s Office, Regional Administrator’s Office) Hot Topics If you have expertise in areas you expect to be hot topics now or in the near future, please identify them. Please let us know what skills you can contribute to EPN: You can check more than one Technical analyses Writing for the public Research on localized consequences of EPA cutbacks Meeting with and/or reaching out to congressional staff in your district Answering questions from reporters, congressional staff and others in your areas of expertise If yes, can we connect you directly with reporters, congressional staff and EPN partner organizations when they have a specific question in one of your areas of expertise Website design & maintenance Google Docs/GSuite Other IT support Social media (Facebook, Twitter, etc.) Media outreach Other outreach and coordination Willingness to help out with grunt work as needed Please let us know if you have (and would be willing to contribute) good working relationships with specific people in the following areas who could assist with achieving the mission of EPN: You can check more than one Media Congress (including staff) Other Federal government State and local government Other opinion leaders of any sort Funders Wrapping Up About many hours per week, on average, could you devote to this organization's work, if needed? You can check more than one 0 to 1 1 to 2 2 to 3 3 to 5 5 to 10 10 to 15 15 to 20 More than 20 I'm interested only in receiving emails and/or making occasional contributions to EPN Please tell us more about what you might like to participate in with EPN; and please tell us anything more about yourself (special capabilities, experience, current job, etc.) that may be relevant to your participation. At some future date, can we upload your contact information and your areas of expertise to an online password protected directory for future networking? Please press the "Submit" button below. Thank you very much!
