CESA Membership Application Form

To join Clean Energy States Alliance (CESA), please fill out the following pages with the information requested. For assistance or more information, please contact MariaBlais Costello at (802) 223-2554 x203.

Please select your membership category:

□Full Member

Full members are states, cities, and other sub-national entities that administer public dollars for clean energy, as well as publicly owned utilities—provided that the utility makes funding available to the public for clean energy projects, market building, or related activities.

CategoryAnnual Renewable Energy Budget

□New MemberN/A

□Group Six<$3 million/year

□Group Five$3 million - $ 9 million/year

□Group Four$9 million - $14 million/year

□Group Three$14million - $20 million/year

□Group Two$20 million - $30 million/year

□Group One>$30 million/year

Dues: The first year’s dues for New Members, regardless of size, are $10,000. The base membership starts at $10,000 (for Group Six Members) and is assessed based upon the specific size of the Member’s annual renewable energy budget. For a specific calculation of dues for your organization or more information, please contact Maria Blais at or at (802) 223-2554 ext. 203.

Affiliate Member

Any public or nonprofit organization that is not eligible for CESA Core Membership can apply for CESA Affiliate Membership. Among the types of organizations that are eligible for CESA Affiliate Membership are NGOs, universities, economic development organizations, and technology transfer offices, as well as cities, counties, and states that do not have significant dedicated clean energy funding. Affiliates must be approved both by the CESA state member in which the entity is located, if applicable, and the CESA Board of Directors.Affiliate status is not open to private developers orbusinesses.

Dues: Affiliate Member annual dues are $2,500.(Membership fee waived for state agencies included in a CESA Core Member’s membership.)

Please fill out the following information and return this form to Maria by mail, email, or fax to

802-223-4967.

Date:
Organization Name:
Department:

Lead Contact Name:
Lead Contact Email:

Address 1:
Address 2:

City: State: Zip Code:

Phone:

Website:

Payment Information

Full Members

Full Memberships run July 1 of the current year to June 30 of the following year. Upon receipt of this form, we will send you the Full Member MOU as well as an invoice. Your membership will be pro-rated depending on what month of the year you join, and will become active as soon as your payment is received. Please email your completed form to Maria Blais at , submit it via fax at (802) 223-4967, or mail it to the address below:

Affiliate Members

Affiliate Membership applications will be reviewed and we will notify you within four weeks of application. Please email your completed form to Maria Blais at , submit it via fax at (802) 223-4967, or mail it to

Clean Energy States Alliance

c/o Maria Blais Costello

50 State St., Suite 1

Montpelier, VT 05602

Note: We do not accept credit cards.

Please let us know if you have any questions.

Clean Energy States Alliance 50 State StreetMontpelier, VT 05602

(802) 223-2554  fax (802) 223-4967

Email: