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Climate Justice Alliance Member Application Form
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Contact 1
Membership Application Form
First Name of person completing this application
Last Name of person completing this application
Name of Organization
Organizational Information (description):
Street Address
City
State
- Select -
Zip Code
Email
Phone Number
Twitter Handle (please enter as https://twitter.com/yourhandle)
Website (Main)
Website (other)
Primary Contact Information:
Primary Contact Name
Primary Contact Email
Primary Contact Phone
Alternate Contact Information:
Alternate Contact Name
Alternate Contact Email
Alternate Contact Phone
Please share the name of person/organization that recommended you apply
Organization's Mission
My organization falls under the following category(ies):
Base building frontline organization
Union or Worker Center
Regional / National network or alliance
Movement support Organization
Other
If Other, Please Specify:
Please list 3 main issues that your organization works on:
Which of these Just Transition sectoral shifts does your organization work on (Check all that apply):
Energy Democracy (Clean Community Energy)
Food Sovereignty, Water, and Land
Zero Waste
Public Transportation
Efficient, Affordable, and Durable Housing
Ecosystem Restoration and Stewardship
Briefly describe the methods and strategies of your work:
Who are your main constituency or partners (if applicable):
Where is your geographic focus (sample regions based on Bureau of Economic Analysis):
New England (CT, ME, MA, NH, RI, VT)
Northeast/Mid-Atlantic: (DE, DC, MD, NJ, NY, PA)
Great Lakes (IL, IN, MI, OH, WI)
Plains (IA, KS, MN, MO, NE, ND, SD)
Southeast (AL, AR, FL, GA, KY, LA, MS, NC, SC, TN, VA, WV)
Southwest (AZ, NM, OK, TX)
Rocky Mountain (CO, ID, MT, UT, WY)
Far West (AK, CA, HI, NV, OR, WA)
Indian Country
National
International
How many members do you have:
What other local, regional, national or international coalitions, networks or alliances is your organization a member of?
What is your approximate budget:
Less than $100k
$100k - $499k
$500k - $1M
$1 - $2,000,000
$2,000,000+
Eligibility & Commitments
Please check the following boxes that indicate eligibility below:
We support the Goals, Strategies and Agenda of CJA and commit to engage in work to advance the Campaign (See previous page)
We support the Climate Justice Alliance Manifesto (See previous page)
We support the Climate Justice Just Transition Principles (See previous page)
Should my organization be selected for membership, we will commit to the following (Please check all that apply):
We will adhere to the Jemez Principles for Democratic Organizing (See attached)
We will participate on Full membership monthly calls
We will link the Our Power Campaign website to our social media and on our organizational website
Yes, I agree to pay annual dues before September 1st of every year.
Yes, I agree to participate in a work group and move forward the CJA strategy plan.
If you selected that you will serve on a working group above, please indicate if you will focus on:
Energy Democracy Working Group
Food Sovereignty Working Group
Political Education Working Group
Reinvest in Our Power Working Group
Convenings/Mobilization Planning Groups
Membership Development Committee
CJA staff and Steering Committee members will work with all new member organizations to develop a Memorandum of Understanding to lay out more specific mutual commitments. Please click on the box below if you agree to this.
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