Organization Information

Company


Street Address


City


State/Province


Zip

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Office or Building Square Footage:


Year Building Built:


Sector:
Office Retail Restaurant Hospitality Institution Government Architecture Engineering Non-Profit Law Firm Technology Media/Journalism Product Development/Sales Financial Services Professional and Business Service Education Health Services Other

Please Specify if Sector is "Other":


Number of Full Time Employees:

Business Location: Yes No

Is your business operated out of your residence or commercial building?: Commercial Residential Other
Please Specify if "Other":

Do You Rent or Own?: Own Rent

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Contact Information

Primary Contact
First Name

Last Name


Email



Secondary Contact (optional)
First Name


Last Name


Email


Phone

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Competition Entry

Which area would you like to compete in? (chose one):
Start Smart Scorecard All Access Scorecard Water Purchasing Leadership Transportation Energy Waste MVP

How did you hear about the Challenge? (select all that apply):
(Select more than one by holding the Ctrl key and clicking each option.)
Colleague or friend Conference Internet City employee Brochure or advertisement Local media Other

Please Specify if "Other":


Pledge
To offset the cost of the education, trainings, networking and resources, we will be asking business to consider a financial contribution. To ensure the ongoing success of the Better Business Challenge, please consider making a donation to this program of Better World Betty and LEAP (both non-profit organizations). We will be asking for donations at the end of 2013 and in the final months of the program in 2014. Thank you!

Yes, we will consider this.

We'd like to give now:



Confidentiality Notice
Participant scorecard data will remain entirely confidential and will not be shared with the public. Scorecard data will be used for verification purposes and evaluating program results. Only the Better Business Challenge Team will be able to access the information. We do, however, want to brag about your success and we will publicize SUCCESS frequently and often through television, radio, print, and online!

Final results may include total participant cost savings, total energy, water, waste savings, total number of actions, etc. Participants will be asked to provide a limited amount of documentation at the time of final scorecard submission (May 15, 2014). We will randomly choose 12 action items for verification. The Challenge team can ask for verification documents when selecting Challenge winners.

We have read and agree with the Confidentiality Notice

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Help us understand your needs (optional):

1- Has your business recently completed a sustainability or efficiency project?:
Yes No

2- What was your motivation in pursuing?:


3- Is there a sustainability or efficiency project your business is planning in the future?:
Yes No

4- What is your motivation in pursuing?:


Any other information you'd like to share:

Thanks! We will send you a username and password shortly.

Our lunch n' learn series and happy hours will be held in order to give Challenge participants the tools and resources necessary to help them achieve their Challenge goals!

Questions? Please contact