Waste Knot Program Application Form

Company Name: (Required)

Address: (Required)

Include street address, city, state and zip.

Contact Person: (Required)

Title:

Phone Number: (Required)

Fax Number:

E-Mail Address: (Required)

Website Address:

Number of employees at this location:

Type of Company:

How did you hear about this program?

Chamber of Commerce

Radio

Newspaper

Website

Other

If Other (above) please elaborate:

Section 1: Waste Reduction and Reuse

Waste Reduction is any activity which eliminates or reduces solid waste that would otherwise be thrown away or recycled.

Has your organization been able to decrease its garbage collection as a result of recycling?

Yes
No
Don't Know

Select the type of garbage collection service you use:

Contract with waste collection service
Property manager provides waste collection service
Garbage collection provided by the city/municipality
Self-haul garbage to transfer station

Select all of the following activities that occur within your facility

To select multiple entries, hold down the control (Ctrl) key while making your selections.

If Other (above) please elaborate:

Select all of the following items that are reused on a regular basis within your facility:

To select multiple entries, hold down the control (Ctrl) key while making your selections.

If Other (above) please elaborate:

Section 2: Recycling

Select the materials that are recycled at your facility:

To select multiple entries, hold down the control (Ctrl) key while making your selections.

If Other (above) please elaborate:

If you use a recycling collection service, list the recycling service:

If you take recyclables to a recycling facility, list the facility:

How many times a week is your recycling collected?

How many containers are collected?

Section 3: Using Recycled Content Products

Recycled content products are made with materials that have been used and collected for recycling. When you purchase recycled content products, you support the recycling process by creating a market for recyclable materials.

Does your company have a formal purchasing policy regarding recycled products? (purchase of post-consumer content products, chlorine-free paper, etc.)

Yes
No
Don't Know

From the list below, mark all the products you use that are made with recycled materials. If in doubt, ask your suppliers which of your products have been made with recycled materials.

To select multiple entries, hold down the control (Ctrl) key while making your selections.

If Other (above) please elaborate:

Why does your organization deserve special recognition as a Waste Knot Partner?

Include any activities or practices that may not have been sufficiently covered in the above sections. Please include information on any other sustainable environmental practices in which your business participates, such as integrative pest management, use of less toxic alternatives, and water efficiency measures. If applicable, provide any information about recycling rates, new programs, and dollars saved from waste reduction and recycling practices (e.g. tons of paper collected, dollars per year saved, etc.):

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