Fleet Decarbonization Accelerator Enrollment Form

Fleet Decarbonization Accelerator Enrollment Form
Thank you for your interest in the Breaking Barriers Collaborative’s Fleet Decarbonization Accelerator. To enroll in the Accelerator please complete and submit the form below no later than January 17, 2023. We will contact you within 2 weeks of receiving your enrollment form. We may have follow-up questions to ensure that your business is setup to successfully complete the program. To learn more about the Accelerator visit our website.

The Accelerator is limited to 20 businesses and we aim to have a diverse group of businesses from across Washington and Oregon, including BIPOC-owned businesses. Enrollments are reviewed on a rolling basis, so we encourage businesses to submit their enrollment early. If the program has been filled we expect to run a second cohort in the fall of 2023.
Company Information
Company Name*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Industry*
Company Size*

Less than 56 – 1011 – 2526 – 5051 – 100101 – 500More than 500
Is this a majority BIPOC-owned business?*

YesNo

Participant Information
You must enroll at least one participant, and may enroll up to three additional participants. The primary participant must be the fleet manager or equivalent position that operates your fleet. Other participants may include someone from building operations (relevant to charging infrastructure) and finance (to help build the business case), and your sustainability team (if you have one).
Participant 1*

First NameLast Name
Position/Title*
Email*
example@example.com
City*
State*

WashingtonOregon
Participant 2

First NameLast Name
Position/Title
Email
example@example.com
City
State

WashingtonOregon
Participant 3

First NameLast Name
Position/Title
Email
example@example.com
City
State

WashingtonOregon
Participant 4

First NameLast Name
Position/Title
Email
example@example.com
City
State

WashingtonOregon

Acknowledgement of Commitments
- A minimum of one (and up to four) participants attend and actively participate in 60 - 90 minute weekly online sessions. Sessions run between February 1st and April 26th. There is no session on February 22nd.
- Participant(s) attend a one-day in-person session on February 15th in Seattle.
- Participants create a fleet decarbonization plan and presentation by the end of the program
- Company executive (VP or higher) to sponsor your organization’s participation in the program
- $950 per company fee (financial support available if needed)
I acknowledge the commitments for my company to participate in the Breaking Barriers Collaborative Fleet Decarbonization Accelerator.
Should be Empty:

Company Information