KCB Partner and Affiliate Application

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* 1. Contact Information

Main Contact Name

City, County or Region

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Shipping Address, If different from above

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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* 3. What is estimated population of proposed affiliate?

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* 4. Are you applying on behalf of an existing organization or government committee/commission? If so, please list the name.

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* 5. Please identify the organizational structure of the existing organization, if applicable.

No existing organization

City Government

County Government

Civic Organization

Chamber of Commerce

Nonprofit

Other (please specify)

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* 6. Partner and Affiliate Commitment:
We agree to either:
Option 1: pay an annual fee of $200
Option 2: document 10 hours of volunteer time for cleanup, fixup, or beautification of the community within 12 months OR participate with KCB on a designated project.

Option 1: Send a check for $200
Keep California Beautiful
10265 Rockingham Dr
Ste 100 PMB 6137
Sacramento, CA 95827

Option 2: Document Ten (10) Volunteer Hours by one or more individuals in the space below. Please provide the number of volunteers, the number of hours, and a brief description of the cleanup, fixup, beautification, or educational project(s) in the past twelve months. If participating with KCB in DWR or EPA project type KCB2023 only.

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* 7. Requirement Acknowledgement:
With the acceptance of the application, the applicant will move into Provisional Partner/Affiliate status. Over the next 3 months, KCB will work with the applicant to complete the items below.

Determine the organizational structure and board membership (committee of an existing organization encouraged)

Conduct a community litter or needs assessment (DWR/EPA/KCB Environmental App) or share the priority list (instruction provided by KCB)

By typing your name, you acknowledge you have read and understood the steps.

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* 8. Annual Requirments Acknowledgement:
Each affiliate must complete the following requirements each year between July 1 and June 30:

Submit $200 Annual Dues or document equivalent volunteer time 10 hours

Participate in at least ONE activity every year such as

KCB K-12 School Challenge (February)

KCB Environmental App to document cleanups and prevention

Clean California Community Day event

Arbor Day Celebration (March)

International Coastal Cleanup (September)

Make A Difference Day (October)

America Recycles Day Event (November)

Great American Cleanup (March-May)

Adopt-a-Highway or road program

Recycling and/or Reuse Collection

Participate in training, e.g., affiliate calls/webinars (2 at 1.5 hours) or other training provided by CRRA, Calrecycles, or other KCB partners.

Submit an Annual Survey and Report with general information, including the number of volunteers and volunteer hours (1 hour)

By typing your name, you acknowledge you have read and understood the Annual Affiliate requirements.

KCB Partner and Affiliate Application

Question Title

* 1. Contact Information

Question Title

* 2. Shipping Address, If different from above

Question Title

* 3. What is estimated population of proposed affiliate?

Question Title

* 4. Are you applying on behalf of an existing organization or government committee/commission? If so, please list the name.

Question Title

* 5. Please identify the organizational structure of the existing organization, if applicable.

Question Title

* 6. Partner and Affiliate Commitment: We agree to either: Option 1: pay an annual fee of $200 Option 2: document 10 hours of volunteer time for cleanup, fixup, or beautification of the community within 12 months OR participate with KCB on a designated project.

Question Title

Question Title

* 6. Partner and Affiliate Commitment:
We agree to either:
Option 1: pay an annual fee of $200
Option 2: document 10 hours of volunteer time for cleanup, fixup, or beautification of the community within 12 months OR participate with KCB on a designated project.