Business Name

Type of Business (Retail, furniture, restuarant, etc)

Contact Person

Additional Contacts

Phone

Area Code:

Number:

Mailing Address

Email Address

Mentor: Agree to act as a mentor to another business, offering information and technical assistance, facility tours, etc.

• Agree

Are there any environmental accomplishments you wish to highlight? (May be featured on county’s website)

Set one or more significant goal(s) in the areas of Recycling, Waste Reduction, Reuse and Buy Recycled. See help sheets for ideas.

Submit