Partners for Clean Air Annual Membership Pledge

State Form 56138 (R4 / 11-20)

1. My interest in Partners for Clean Air is as an:
2. Name:
3. Title (if applicable):
4. Organization (if applicable):
5. Address:
6. City:
7. State:
8. ZIP Code:
9. Phone (with area code):
10. Fax (with area code):
11. E-mail Address:
How I (my organization) would like to be involved with Partners for Clean Air (PCA):
12. Membership Level for 2021:
Gold Membership
Silver Membership
Bronze Membership
Green Membership
13. I (we) pledge to do the following:
Link with carpooling and vanpooling resources.
Use bike racks and encourage bike riding to all destinations.
Carpool to work and inquire about preferred parking.
Offer/ use public transportation to offset costs.
Use a telework program at work.
Start a ride-share program with co-workers.
Pack a lunch or walk to lunch; organize group deliveries from local restaurants.
Turn off all equipment and lights when not in use.
If possible, work a flexible schedule and commute during non-peak driving times.
Use teleconferencing instead of driving to meetings.
Properly recycle office products, including paper, ink cartridges, batteries and old electronic equipment.
Properly recycle paper, plastic, glass bottles, aluminum cans and cardboard.
Reuse materials like paper bags and boxes.
Purchase only 100% recycled paper for the home and office.
Start a composting bin.
Participate in company-sponsored environmental initiatives or help create one.
Place reminders in vehicles to help limit engine idling time to less than 30 seconds. Idling for just 30 seconds uses more fuel than stopping and starting your engine.
Avoid excessive idling or jackrabbit starts.
Keep vehicles well maintained.
When possible, fill gas tank during the cool evening hours to reduce evaporation; avoid refueling your vehicle on Air Quality Action Days.
Park and go inside at restaurants; avoid drive-thru windows and congested areas to save fuel and time.
Delay using gas-powered recreational vehicles on hot, sunny days. Small engines are a significant source of air pollution.
Replace inefficient boilers or furnaces with newer energy efficient models.
Convert combustion processes to cleaner burning fuels.
Use environmentally friendly cleaning products.
Replace incandescent lighting with compact fluorescents.
Purchase only Energy Star office equipment.
Set all computers to sleep mode or to turn off, as opposed to using screen savers and ensure that all lights and computers are off at the end of the day.
Set your thermostat 1-3 degrees lower in the winter and 1-3 degrees higher in the summer.
Seek/ provide rewards to departments that quantifiably reduce energy.
Offer incentives to employees to reduce commute vehicle usage.
When possible, limit production operations to conserve energy.
Provide an outdoor picnic area for employees.
Provide preferred parking for carpools and vanpools.
Obtain transit maps for nearby routes to frequent destinations.
Provide onsite mailing and/or copying services.
Arrange for onsite dry cleaning drop-off and pick-up at your workplace.
Use direct deposit of checks.
Use a 9/80 or 4/10 work schedule to reduce trips to work.
Use telecommuting at work.
Subsidize mass transit for employees.
Use a video teleconferencing system.
Use onsite banking services.
Use/ provide onsite childcare.
Use/ provide onsite exercise facilities.
Adopt a green contracting policy for procuring goods and services.
Adopt a clean fleet procurement policy.
Schedule an energy audit and implement energy efficiency measures.
Use solar power, wind and geothermal technology.
Shift or eliminate the operation of equipment to minimize air pollution during peak afternoon hours.
Plant deciduous trees around your home/ office to provide shade in the summer and to allow light in the winter.
Write in your own suggested action:
14. Write in your own suggested action:
Other actions to do at home:
  • Mow after 7:00 PM.
  • Keep household paints, solvents and pesticides in air-tight containers.
  • When you barbeque, use a charcoal chimney or electric starter instead of lighter fluid.
  • Use only water-based paints and solvents.
  • Do not burn leaves and other yard waste.
To complete this registration, please click the "Submit Survey" button below.