Thank you for your interest in CivicWell membership!

Once you complete your application you will be directed to your payment options. You may either

pay online or request to be invoiced. If you have questions or problems with this form, contact

members@civicwell.org

Primary Contact

Alternate Contact (optional)

Membership Options

Membership status *
Membership Level *

Agency - Cities, counties, special districts, and state agencies—annual fee depends on population served. Entitles 10 people to membership benefits. Once you select "Agency" as your Membership Level, you will be able to enter the contact information for the people below.

Change Maker - Individual local elected officials, government staff, CBO staff, community leaders, and supporters. Includes an acknowledgment on our social media.

Leader - Individual local elected officials, government staff, community leaders, and supporters.

Student - Students, CivicSpark Fellows, and CivicSpark alumni.

Agency Member Contact Information

Please enter the contact information for the up to 10 members you would like to have under your Agency membership.

Focus Areas

What are your focus areas? (Check all that apply) *
 

Assistance

What would you like assistance with as a member of CivicWell? (Check all that apply)

Community Vision and Smart Growth Successes

In an effort to better meet the needs of our members we would like to gather some information regarding our members' vision for a great community and smart growth successes.
The CivicWell national network is made up of policymakers and emerging leaders. Together, our members pursue innovative smart-growth and climate resilience strategies, seek new partners and tools to build thriving communities, strengthen local economies, and enrich the lives of all residents.

With the help of our network of visionary local elected officials and community leaders, we work to transform communities by inspiring each other and sharing promising strategies for resilient and equitable communities. As a CivicWell member, you will have access to our direct assistance and practical tools for implementing on-the-ground successes in your community.
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