Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Western Washington Clean Cities Membership Application

  1. 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.

  2. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) 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 3) you may still be required to provide a traditional signature at a later date.

  3. Leave This Blank:

  4. This field is not part of the form submission.