​By submitting this form I agree to promote the values and visions of the Trust at all times, to work with other Green Ambassadors and the Environmental Sustainability Steering Group to create and ensure positive experiences for patients, the public and colleagues.

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* 1. Name

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* 2. Role

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* 3. Email address

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* 4. Department

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* 5. Site

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* 6. As a green ambassador I would be interested in being involved in the following areas (please tick all that apply)​

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* 7. Have you, or your team introduced an green initiatives within your areas of work?

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* 8. Any other comment or suggestions. e.g how do you feel you can shape change or influence the sustainability agenda in your work area​

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