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. Affiliate Fee Commitment:
We agree to either pay an annual fee of $200 OR document 10 hours of volunteer time for cleanup, fixup, or beautification of community with 12 months.

Option 1: Send a check for $200
Keep California Beautiful
8665 S. Union Ave
Bakersfield, CA 93307

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 KCB2021 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)

Agree to use the name Keep “Name” Beautiful if a newly forming organization but not required of organizations with an established identity

Prepare mission statement (sample provided)

Prepare bylaws, organization guidelines, an ordinance, and/or a resolution for the organization (sample provided)

Conduct a community litter or needs assessment (DWR/EPA/KCB Environmental App) or share priority list previously created

Establish a budget; this may be in-kind

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 Environemtal App to document cleanups and prevention

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

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. Affiliate Fee Commitment: We agree to either pay an annual fee of $200 OR document 10 hours of volunteer time for cleanup, fixup, or beautification of community with 12 months.

Question Title

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* 6. Affiliate Fee Commitment:
We agree to either pay an annual fee of $200 OR document 10 hours of volunteer time for cleanup, fixup, or beautification of community with 12 months.