Introduction:

Washington’s Clean Energy Transformation Act (CETA) passed by legislature in 2019 requires utilities to ensure an equitable distribution of energy benefits and a reduction of burdens on vulnerable populations and highly impacted communities.

There are many societal issues that run parallel with the desire to convert to a clean energy future. Based on your unique experience, please review the information below to indicate your interest in advising Avista in these matters.

Advisory Group Member Qualifications

Knowledge, skills, and experience (lived and professional) to effectively represent your respective community/population/group.

Capacity and willingness to serve as the conduit or intermediary between the Equity Advisory Group (EAG) and the entity you represent.

Availability to attend regularly scheduled meetings.

The following information collected will be used to understand your interest and capacity to participate in the Equity Advisory Group as well as to track the experiences and communities/sectors that are represented.

Go to https://www.myavista.com/about-us/washingtons-clean-energy-future for more background.

Please submit completed forms by email to dan.blazquez@avistacorp.com or by mail to:

Avista

MSC-68, attention: Dan Blazquez

1411 E. Mission, Spokane WA 99202

Member Information

Full Name:	Date:
Last	First	M.I.
Address:
Street Address	Apartment/Unit #
City	State	ZIP Code

Phone: ________________________________	Email Address: ________________________________

Preferred method for communication:

☐ Phone

☐ Email

☐ Face to face

☐ Other: ______________________________________________________________________

Additional Resources

Resource Link	Description
Washington’s Clean Energy Future	Avista page for CETA related activities
Clean Energy Transformation Act	Clean Energy Transformation Act - Washington State Department of Commerce
Chapter 19.405 RCW	Laws and Regulations: Revised Code of Washington Investor-owned utilities
Chapter 480-100 WAC	Laws and Regulations: Washington Administrative Code Investor-owned utilities
WA Energy Strategy	Washington State Energy Strategy from the WA Dept. of Commerce
CETA Overview	CETA overview and interim assessment from the WA Dept. of Commerce

Interest

In what way would you like to engage with the EAG?

☐ Actively participate as an EAG member

☐ Both actively participate and receive information/updates.

☐ Receive information/updates on the activities of the EAG.

☐ Other: ______________________________________________________________________

What are your interests in joining Avista’s Equity Advisory Group?

________________________________________________________________________________________

________________________________________________________________________________________

Are you interested in joining Avista’s Energy Equity Advisory Group as an: (check all that apply and provide)?

☐ Individual community member, leader, or worker who is interested in Washington State’s Clean Energy Transformation law.

Please describe: _________________________________________________________________

☐ Partner from an organization, business, or union that serves communities or workers.

Please describe: _________________________________________________________________

☐ Partner from an industry, sector, or governmental agency.

Please describe: _________________________________________________________________

☐ Other with description: ________________________________________________________________

How will participating in the Group benefit your community/sector/organization? _______________________________________________________________________________________

_______________________________________________________________________________________

Experience

Please provide information about your background or experience that may inform ways to make improvements to the following areas: (check all that apply)

☐ Employment	Please describe: _________________________________________________

☐ Food insecurity	Please describe: _________________________________________________

☐ Healthcare	Please describe: _________________________________________________

☐ Housing	Please describe: _________________________________________________

☐ Language barriers	Please describe: _________________________________________________

☐ Transportation	Please describe: _________________________________________________

☐ Other:	Please describe: _________________________________________________

Please identify community affiliations in which you have personal and/or professional experience. We understand there may be intersecting personal identities and/or professions. Select all that apply.

☐ Academic partner, please note which institution: ____________________________________________

☐ Community based organization, please note which organization: _______________________________

☐ Community member, advocate and representative for people in congregate settings: people experiencing homelessness, people who are detained/incarcerated, etc.

☐ Community member, leader representing American Indian/Alaska Native communities

☐ Community member, leader representing immigrant and refugee communities

☐ Community member, leader representing individuals with disabilities

☐ Community member, leader representing rural and frontier communities

☐ Community member, leader representing the African American/Black communities

☐ Community member, leader representing the Asian American communities

☐ Community member, leader representing the Latinx communities

☐ Community member, leader representing the LGBTQIA+ community

☐ Community member, leader representing the Native Hawaiian and other Pacific Islander communities

☐ Community-led groups or coalition, please note group: _______________________________________

☐ Faith based community

☐ Government Agency, please indicate: ____________________________________________________

☐ Local Health Jurisdiction

Please note tribe: ___________________________________________________________________

☐ Other: _____________________________________________________________________________

Compensation

We value and honor your time, and compensation may be available to you or your organization to cover the cost of your participation at Equity Advisory Group meetings.

Would you like to be compensated for your time?

☐ Yes

☐ No

☐ Other comment(s): ___________________________________________________________________

Participation

Starting January 2024, the Equity Advisory Group will meet monthly with two meeting options for the second Wednesday and Friday of each month. Wednesday meetings are in the early morning (7:30 am to 9:00 am) and the Friday meetings are in the afternoon (12:00 pm to 1:30 am. The group will not meet in December. The schedule for the next few months is:

Wednesdays, 12:00 pm to 1:30 pm	Fridays, 7:30 am to 9:00 am
2024	January 17	January 19
February 21	February 23
March 20	March 22
April 17	April 19
May 22	May 24
June 12	June14
July 17	July 19
August 21	August 23
September 18	September 20
October 23	October 25
November 20	November 22
December 18	December 20

Are you able to attend the meetings?

☐ Yes, I can attend either the morning or afternoon meetings.

☐ No. I am not able to attend but I would like to receive company updates and materials.

☐ Other: _____________________________________________________________________________

To safeguard individual and public health and safety the Equity Advisory Group activity will occur virtually (e.g., through Microsoft Teams and Zoom) until further notice.

How can we best support you with virtual participation? Please check all that apply:

☐ Disability accommodations

☐ Language interpretation

☐ Technology assistance/accessibility (i.e., virtual platform training, phone conference, video)

☐ Other (Please describe): _______________________________________________________________

A requirement of the Washington Utilities and Transportation is that a roster of Equity Advisory Group members is made public. To meet this requirement a roster will be posted at myavista.com/ceta that will include each member’s name, organizational affiliation, and role. Please consider this requirement in determining your willingness to participate in the group.

Other Comments

Please use this space to provide any additional comments you would like to share here:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

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Signature:	Date: