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Apply For/Renew Membership

Download the membership application (PDF) and return to South Shore Clean Cities via email or by mail or fill out our online form below.

Download Membership Form (PDF)

Membership Form

Name*
First Last
Organization/Title*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax Number
Email*
Membership Level*
- Diamond ($5,000)
- Platinum ($3,500)
- Gold ($2,000)
- Silver ($1,000)
- Bronze ($500)
- Associate Partner ($250)
Total
$0.00

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