Application for environmental sustainability services

We'd love to hear from you! Thank you for taking the time to tell us more.

NOTE: Please fill out an application for EACH BUILDING. (all fields are required)


Contact Information




  

Building Information

Please fill in all information for your application to be considered.

  
Do you own or lease this building?   
Are you authorized to make building upgrades?  
Do you pay for energy?    Monthly energy charges ($)  
Do you pay for water?  
If yes, water account #:     Monthly water charges ($) 
Do you pay for waste services?  
If yes, waste account #:     Monthly waste charges ($) 
Does the property have a garden?  

Building Details

How is the building used?  
If residential, how many sleeping units?  
Estimated # of people using the building:  
Number of toilets:  
Number of showers:  
Number of sinks:  
Briefly describe the services provided on the property   
Additional information to better understand the property   

For technical assistance, please send an email to info@connectthedotsnetwork.org.