STAKEHOLDER APPLICATION AND MEMO OF UNDERSTANDING

Please provide the following information...

Please note: This form requires an Email address for each applicant. If you do not have an Email address, click here to download a printable version of this form to be faxed (702-254-4630) or mailed to:

Las Vegas Regional Clean Cities Coalition, Inc.
6771 W. Charleston Blvd., Ste. C
Las Vegas, NV 89146


(*) Starred items are required

* Company:
* Name:
* Title:
* Address:
* City:
* State/Province:
* Zip/Postal Code:
* Office Phone:
Cell Phone: (optional)
* Fax:
* E-Mail:

Commitment Agreement: Please Read All
The Las Vegas Regional Clean Cities Coalition, Inc. was formed in 1993 and designated as the fifth member of the United States Department of Energy's National Clean Cities Program. The Clean Cities Program directly supports the Department of Energy's commitment to energy use in the American transportation section that is more efficient, less dependent on foreign sources, less environmentally disruptive, sustainable and safe. The Energy Policy Act of 1992, supplemented by the 1993 Executive Order 12844: Federal Use of Alternative Fuel Vehicles, and the Clean Air Act Amendments of 1990 all establish guidelines for effecting a favorable energy and environmental situation in the transportation sector. The Department of Energy Clean Cities Program is an umbrella to structure and achieve Energy Policy Act program goals and to coordinate objectives of governments and other Federal directives, such as the Clean Air Act. The key to fulfilling the mission of the Department of Energy Clean Cities Program is for individual stakeholders and their company/organization to support the Las Vegas Regional Clean Cities Coalition. By submitting this Stakeholder Application and Memorandum of Understanding, we commit to helping the Las Vegas Regional Clean Cities Coalition, Inc. achieve its goals and objectives. We understand that our commitments are voluntary, and will be achieved as we have designated in our stakeholder commitment selection below:
Stakeholder Commitment Selection Select at least two areas of commitment
* Commitment Options
	01	Routinely Attend LVRCCC Meetings & Events
	02	Serve on a LVRCCC Committee
	03	Purchase AFVs as appropiate
	04	Develop & Provide Specialized Training
	05	Provide Funding and/or Grants as appropiate
	06	Build, Operate or Maintain Fueling Stations
	07	Other
	Please enter the exact text that appears in the image below:

Send mail to info@lasvegascleancities.org with questions or comments about this web site. Last modified: June 2008