Green Leader Application for Large Commercial or Industrial Businesses

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Rockford Sustainability Committee invites our local businesses to advertise their environmental stewardship by filling out this application. Successful applicants can receive one of three designations - Gold, Silver or Bronze by scoring points in each of our four categories.

To qualify, a business or organization must perform a minimum of two activities from each category. Each activity is worth one point, unless otherwise noted. Paragraph answers will be scored by our review team and range from 1-3 points. Applicants must score a total of 10-19 points for the Bronze level, 20-29 points for the Silver level, and 30+ points for the Gold level. You may leave questions blank.

Once your application has been approved by our committee, your business will be awarded a Green Leader window sticker designating your level of achievment. Display this logo proudly in a prominent location to let your customers know of your commitment to a sustainable community! We will also help you advertise your achievement on our social media and in our local newspaper.

If you have questions or pictures that will help clarify your actions and help us promote your business, please email them to RockfordSusCom@gmail.com.

Thank you for your participation!

Email *

Green Leader Logo

Name of Business/Organization *

Contact Person *

Phone Number *

Do you own or rent your business space?

(We recognize that some questions may not apply if you do not own your space.)

Own

Rent

CATEGORY 1: REDUCING WASTE

Our business recycles.. (check all that apply)

paper

plastic

cardboard

glass

metal

Other:

Please explain any hard-to-recycle items that you recycle (e-waste, toxic waste, styrofoam, etc.)

Tell us about any other recycling programs you participate in, such as TerraCycle, to recycle special items.

We offer in-house recycling. Please explain.

We compost organic materials such as food or yard waste or materials used in making our product(s). Please explain.

What other actions have you taken to elimate single use plastics?

Explain any other actions you have taken to reduce landfill waste.

CATEGORY 2: RESOURCE CONSERVATION & AIR QUALITY

Our facility has the following energy certifications:

Energy Star

LEED

National Green Building Standard

Other:

Clear selection

Our business has the following water saving devices:

Low-flow toilets

Water tap aerators

Rain barrel(s)

Other:

Our manufacturing processes incorporate waste water treatment and reuse.

Yes

Clear selection

Our equipment cleaning processes are automated to reduce water usage.

Yes

Clear selection

We participate in "Adopt a Drain" program by keeping our nearby storm drain(s) clear. (1 pt.) (Learn more at https://www.lgrow.org/adopt-a-drain)

Yes

Clear selection

Please explain any other water conservation efforts (grey water for plants, etc.)

Our business has the following energy saving devices:

LED lighting (no incandescent bulbs)

Energy efficience light switches (timers to go off when room not in use)

Programmable thermostat

Smart thermostat

Zoned heating and cooling

Power strips for electronic devices

Smart power strips

Energy Star appliances (2 pts)

Ground or air source heat pump for heating and cooling (3 pts)

Solar panels (3 pts)

Other:

We have performed a free energy audit in the past year with our utility company.

Yes

Clear selection

We have hired an energy consultant to perform an audit in the past year (2 pts.)

Yes

Clear selection

We have an indoor air filtration system (2 pts)

Yes

Clear selection

We have room air purifiers

Yes

Clear selection

We use low VOC paint on all painted surfaces.

Yes

Clear selection

We track our energy and water usage through Energy Star Portfolio Manager or a similar software. Please explain. (2 pts)

We have conducted a Greenhouse Gas Inventory (If yes, please explain. Benchmark year?)

We are enrolled in a Green Energy program through our utility company or other source. Please explain.

We encourage "no idling" with signage in our parking area

Yes

Clear selection

CATEGORY 3: STEWARDSHIP & TRANSPORTATION

We source locally produced products in our business. Please explain.

We offer products that are sustainably produced. Please explain.

We practice responsible landscaping by...

planting native flowers and grasses

planting native trees

composting our yard waste

minimizing lawn

minimizing the use of gas powered equipment like mowers, blowers, string trimmers, etc.

NA - there is no lawn associated with this business

Clear selection

We encourge sustainable transportation for our employees and patrons by:

implementiing a carpooling program

providing an incentive program (Ex: bonus for walking or biking 5x a month)

friendly competition program (Ex: Healthy Hero of the Month)

providing charging station(s) for employees who drive electric vehicles (2 pts.)

Other:

Clear selection

Please explain other activities you feel qualify for this category. (This can include multiple activities for extra points. Ex: employee participation in invasive plant removal, river clean up, trash pick up, etc.)

CATEGORY 4: COMMUNITY & POLICY

We have received the following environmental certifications

ISO 14001

B Corp

Green Seal

Green Business Bureau

Fair Trade

Other:

We partner with other organizations to promote sustainability. Please explain.

We host or participate in a community event that inspires environmental stewardship. Please explain.

We collaborate with other Green Leader businesses to promote sustainability. Please explain.

We have mentored other businesses to become Green Leaders. Please explain.

We regularly promote sustainability on social media and in-house signage.

Yes

Clear selection

We have an internal sustainability director/department?

Yes

Clear selection

We have an internal Green Team.

Yes

Clear selection

We have documented sustainability goals as a business

Yes

Clear selection

We regularly discuss our sustainability goals at staff meetings

Yes

Clear selection

We have a policy in place to train staff on our sustainability initiatives

Yes

Clear selection

Our purchasing policies reflect our commitment to sustainability, even if the price is a little higher.

Yes

Clear selection

We encourage our employees to give back to the community. Please explain.

Please explain other activities you feel qualify for this category.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms