NH Collaborative Social Process Tracking Form

1) Name of the organization who is the implementing partner:
2) How would you characterize your organization:
3) What is the specific name of your program/project? Note: your organization may have several different projects/programs, please fill out the form for each project/program
4) Please list your program/project type: Click here for a description of program/project types.
5) Please describe the program/project in 2 - 3 sentences
6) Step 1 - Select the Overarching strategy (check all that apply)
1. Maximize Energy Efficiency in Buildings
2. Increase renewable and low-CO2-emitting sources of energy in a long-term sustainable manner
3. Support regional and national actions to reduce greenhouse gas emissions
4. Reduce vehicle emissions through state actions
5. Encourage appropriate land use patterns that reduce vehicle-miles traveled
6. Reduce vehicle-miles traveled through an integrated multi-modal transportation system
7. Protect natural resources (land, water, wildlife) to maintain the amount of carbon fixed or sequestered
8. Lead by example in government operations
9. Plan for how to address existing and potential climate change impacts
10. Develop an integrated education, outreach, and workforce training program
6) Step 2 - Select the particular recommended under each action that applies to your effort under each overarchign strategy (check all that apply).
7) What other organizations are partners for this program/project? (please list all)
8) How is your program/project funded? (Select all that apply) Federal Budget Line Item
State Budget Line Item
Municipal Budget Line Item
Project Grant
Formula Grant
Earmark Grant
Donations
9) Are they are other unique resources that support your program/project?
10) Indicate your target group for your program/project Individual
Municipal
Community
Business
School
County
State
Interstate
Regional (Multi-County)
Regional (Northeast)
11) Indicate where your program/project is focused (Select all that apply) State(s)
Count(ies)
Town(s)
12) What tools are being used as part of this program/project to affect change ? (Select all that apply) Education
Outreach
Training
Technical Assistance

Funding
Incentives
Subsides
Grants
Loans

Policy Change
Regulations
Rules

Advocacy
Lobbying
13) What is the intended outcome of this program/project? (Select all that apply)

Mitigation
Energy Efficiency
Energy Conservation
Lower Carbon Fuels-Heat and Power
Offset
Renewable Energy
VMT Reduction
Vehicle Fuel Economy
Lower Carbon Fuels-Transportation
Land Use

Adaptation
Ecological Resilience
Economic Resilience
Infrastructure Resistence
Community Resilience
14) When did you program/project start?
15) When did your program/project end or when will it end
16)  Rate each of the following factors in response to the following question. This factor has been a significant barrier to implementation?
  Significant Barrier Slight Barrier Not a Barrier N/A
Partnerships
Regulations
Legislation
Education
Technical
Training
Awareness
Territorial
Political
Personality
Governance
Resources
17) Discuss how your measure progress for this project
18) Any additional information about this project?
19) Link to program/project website
20) Please provide contact information for the implementing partner/organization:  
     Contact Name:
     Contact Phone:
     Contact E-mail: