FGBC Green Land Development Certification Registration Form

FGBC Green Land Development Certification Registration Form
Submit this form to register for the FGBC Green Land Development designation. It represents your commitment to pursue the certification requirements.

Upon registration, FGBC will assign a Project Evaluator to answer questions regarding the certification process, criteria and required submittals.

A minimum deposit of $500 is required with registration, or you may pay the full application fee when registering.

For more information visit the FGBC website.
Project Information
Project Name *
Parcel ID *

Project Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

County *
Acres *
Website
Designated Professional Information
Full Name *

First Name Last Name
Company

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

- Area Code Phone Number
E-mail *
Developer Contact Information
Full Name *

First Name Last Name
Company *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

- Area Code Phone Number
E-mail *
Version *
Maximum fee for any project is $5,000. Select only the Maximum Project Fee for developments > 3,000 acres.

For all other projects enter the base fee plus the per acre fee.

Fee

Registration Fee $ 500.00

Base Fee $ 2,000.00

Per Acre Fee $ 1.00

# of Acres

Maximum Project Fee $ 5,000.00

Total: $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty: