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Join Coalition for Safe Communities

Business/Organization Member Form

Questions? Email info@safecommunities.com

Name of Business or Organization(Required)

Mailing Address(Required)

Mailing Address City State ZIP Code

Name of Officer Signing(Required)

First Last

Name of Contact Person

First Last

(If Different)

Phone(Required)

Email(Required)

How many Bay Staters do you employ?(Required)

Please check the applicable boxes below, as applicable:

We are interested in getting involved in other ways (e.g., hosting an event, hanging signs, etc.)

In addition to our business/organization as a member, please add my name (i.e., the signing officer) to the list of individual coalition members.

Below, please list any other current or former titles or affiliations you may have, including other job titles, organizational/board positions, volunteer activities, awards, etc. Other current or former titles or affiliations: *(Required)

*Titles and affiliations are for identification purposes only and will be indicated as such on any published lists.

Comments

This field is for validation purposes and should be left unchanged.

Below are answers to some common questions about joining our coalition.

Signing a member form confirms your business/organization’s membership in the Coalition for Safe Communities. By signing this form, you are giving permission for our coalition to list your business/organization’s name publicly as a member of our coalition.
Joining the coalition does not obligate you or your business/organization to contribute any time or money, attend any meetings or make any public statements. Members are welcome to become more actively involved in coalition activities is they wish to do so. However, any involvement beyond being listed publicly is entirely voluntary.
All lists of individual members will note that any titles and affiliations are for identification purposes only, and do not imply the endorsement of affiliated businesses or groups unless expressly indicated.
Member contact information will be used solely for communications between our coalition and members. Member addresses and other contact information will not be sold or provided to any other groups, organizations, or businesses.

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