Request for CERCS Access HiddenNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.Applicant InformationYour Name(Required) Prefix (Optional) Mr.Mrs.MissMs.Dr.Prof.Rev. First Middle (Optional) Last Suffix (Optional) Your Address (Optional) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands How Can We Reach You?Note: Email is a preferred method of contact.Preferred Method of ContactEmailPhoneYour Email Address(Required) Enter Email Confirm Email Your Phone(Required)Best Time to Call You(Required)Select A Time12:00 am12:30 am1:00 am1:30 am2:00 am2:30 am3:00 am3:30 am4:00 am4:30 am5:00 am5:30 am6:00 am6:30 am7:00 am7:30 am8:00 am8:30 am9:00 am9:30 am10:00 am10:30 am11:00 am11:30 am12:00 pm12:30 pm1:00 pm1:30 pm2:00 pm2:30 pm3:00 pm3:30 pm4:00 pm4:30 pm5:00 pm5:30 pm6:00 pm6:30 pm7:00 pm7:30 pm8:00 pm8:30 pm9:00 pm9:30 pm10:00 pm10:30 pm11:00 pm11:30 pmPlease Select The Entity Type You Are Representing(Required)By selecting a choice, the applicant indicates that he or she is an owner or authorized representative or independent individual applying for a CERCS user account. Project (Typically Selected By Nonprofit Organizations) Business Enterprise (For-Profit Endeavors) Unregistered Small Group (Typically Selected By Loosely-Organized Volunteer Groups, Neighborhoods, Etc.) Individual (Typically Selected by Individual Volunteers and Backyard Biochar Makers) Other For This Entity, Please Select Its Operations Classification(Required)IMPORTANT: A CERCS user account may only be associated with one of the following operations classifications. Entities operating under two or more classifications (e.g., kilns and cookstoves) must apply separately for each. Clean Cookstove Operations for Emissions Reduction Clean Cookstove Operations for Emissions Reduction and Carbon Sequestration Kiln Operations for Efficient Charcoal Production Kiln Operations for Efficient Charcoal Production and Carbon Sequestration Heater Stove Operations for Emissions Reduction Heater Stove Operations for Emissions Reduction and Carbon Sequestration Other Details of OperationsWhat Is The Proposed Name Of This Operation?(Required)Please use two or more words. (For instance, “Biochar Pamoja” is the name of operations of a business enterprise in Kenya that is conducting kiln operations for efficient charcoal production and carbon sequestration.) Please Provide A Short Description Of This Operation(Required)Example: Biochar Pamoja (“biochar together”) utilizes the Bungoma County (Kenya) area’s low- and no-value biomass for the production of biochar in Rotatable Covered Cavity (RoCC) kilns that are of 2-barrel length and mounted on wheels for ease of operation close to the biomass supply. The biochar of each operational run is weighed while totally dry (and hot from the kiln). Various biochar production data are captured, recorded, and analyzed using the CERCS CharTrac mobile app. It is continually tracked during any transportation, enhancement, etc. until its final destination when dispersed into soil, leading to verification and certification as long-term carbon dioxide removal (CDR). Start Date(Required)When did or when will operations begin. YYYY dot MM dot DD Please Identify The Principal Location Of This Operation(Required)This should minimally include the Country, State, and County/Province. Localized operations might also include a city name or even a specific address. GPS coordinates may also be used to identify an area (e.g., polygon) or a very specific location.Who Is The Owner Of This Operation?(Required)This is the name of the nonprofit, business, group, or individual that owns the data and any resulting carbon credits/offsets generated by the operation. Note: A CERCS Invitation Code for creating a CERCS user account will be sent to the owner’s email address upon approval of this application. Owner's Email Address(Required) Enter Email Confirm Email Who Is The Manager Of Operations?(Required)If this individual is different from the owner, then he/she will separately receive a CERCS Invitation Code for creating a CERCS user account. First Last Manager Of Operations Email Address(Required) Enter Email Confirm Email Thank You For Completing Your Application For CERCS AccessFollowing our review, we will issue CERCS Invitation Codes via email to approved individuals. Each CERCS Invitation Code is a private, time-sensitive code (valid for 72 hours after issuance) that can be used only by its recipient to create a CERCS user account. They may be used in any app in the CERCS ecosystem (e.g., CERCS CharTrac). Full details are outlined in the invitation email.