Apply for Membership

Thank you for your interest in joining Western Washington Clean Cities!

Please fill out the form below so we can process your application. An invoice will be sent upon approval.

We look forward to working together to advance our region’s economic, environmental, and energy security.

Primary Contact's First Name

Primary Contact's Last Name

Title

Company/Entity

Address 1

Address 2

City

State

Zip

Phone

Website URL

Membership Level & Annual Fee

Select your membership level from the dropdown.

Commitment to Clean Cities

My organization would like to become a member of the Western Washington Clean Cities Coalition.
My organization supports regional efforts to reduce the use of imported petroleum through alternative fuels, advanced vehicle technologies, and fuel efficiency measures.
My organization will undertake efforts, to the best of its ability, to help Western Washington Clean Cities achieve its goals.
My organization will provide information about its use of alternative fuels and advanced vehicle technologies, to the extent applicable and possible, for the Western Washington Clean Cities' annual data collection, which we understand aids the U.S. Department of Energy in program planning.

I agree

Electronic Signature Agreement

By checking the "I agree" box below, you agree and acknowledge that

your application will not be signed in the sense of a traditional paper document,
by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and
you may still be required to provide a traditional signature at a later date.

I agree

Electronic Signature

Date

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