Program Application
YOUR COMPANY INFORMATION-
Company's Legal Name:
*
Company Type:
*
Please Select
Stand-alone Vineyard
Licensed Vineyard Management Company (VMC)
Company Phone Number:
*
Please enter a valid phone number.
Company Mailing Address:
*
Address Line 1
Address Line 2
City
State
Postal / Zip Code
Billing Address (if different):
Address Line 1
Address Line 2
City
State
Postal / Zip Code
Billing Email Address (if preferred)
Primary Contact:
*
First Name
Last Name
Title
Office Phone Number
Mobile Phone Number
*
Email Address
Secondary Contact
*
First Name
Last Name
Title
Phone Number
Office Phone Number
Phone Number
Mobile Phone Number
Email
*
Email Address
Do you participate in another sustainability program? If so, which one(s)?
Does your company have any special customer requirements or customers who require certification?
No
Unknown at this time
Yes (please explain)
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VINEYARD INFORMATION-
What is the total number of winegrape acres you farm and/or manage?
*
Scope of Certification:
*
Please Select
Entire vineyard (i.e., all vineyards)
Subset of the operation (i.e., only some vineyards)
List all the vineyard(s) in the rows that will have a separate self-assessment. It is recommended to simplify down to as few blocks as possible. A self-assessment should be performed for each “management unit.” A management unit is a single vineyard, or a group of vineyards managed similarly. List vineyard names exactly as you want them on your certificate and in the Sustainable WA self-assessment platform – this must be consistent across the fields table in this application and the self-assessment system.
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AUDIT INFORMATION-
Contact for Audit (if different than Primary Contact):
First Name
Last Name
Title
Office Phone Number
Mobile Phone Number
Email Address
Mailing Address Line 1
Mailing Address Line 2
City
State
Postal / Zip Code
Address for Audit Location
*
Street Address Line 1 (If vineyard blocks do not have addresses, please provide coordinates in the form of latitude and longitude)
Street Address Line 2
City
State
Postal / Zip Code
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WORKFORCE INFORMATION-
Number of Full-Time Employed Workers (if not applicable, enter "0"):
*
Directly employed labor
Number of Part-Time/ Temporary Employed Workers (if not applicable, enter "0"):
*
Directly employed labor
Number of Farm Labor Contractors (FLC) or Other (if not applicable, enter "0")
*
Contracted labor
Percentage of Non-English Speaking Workers:
*
A rough estimate will work
Submit
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