Thriving Faith Communities Application
Please complete the application below to get started as a Thriving Faith Community. You can save the application to continue later through the button at the bottom of the form. Please reach out to us if you have any issues or questions at elena@faithinplace.org
Your Name
*
First Name
Last Name
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Email
*
example@example.com
House of Worship Information
House of Worship Name
*
House of Worship Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
House of Worship Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Main/Office Email
*
example@example.com
House of Worship Website
Size of Your Congregations: Please select unit of measure
Please Select
# of Households
# of Individuals
Size
House of Worship Contacts
House of Worship Contacts
Please share 2-4 names of contacts (clergy, lay leaders, volunteers, etc) at your House of Worship.
Name of Contact 1
*
First Name
Last Name
Email for Contact 1
*
example@example.com
Role at House of Worship for Contact 1
*
Name of Contact 2
*
First Name
Last Name
Email for Contact 2
*
example@example.com
Role at House of Worship for Contact 2
*
Name of Contact 3
First Name
Last Name
Email for Contact 3
example@example.com
Role at House of Worship for Contact 3
Name of Contact 4
First Name
Last Name
Email for Contact 4
example@example.com
Role at House of Worship for Contact 4
Thriving Faith Communities Project Team
Project Leader Contact Info
This is the primary contact for the initiative who will attend all learning events
Project Leader Name
*
First Name
Last Name
Project Leader Email
*
example@example.com
Role at House of Worship of Project Leader
*
Project Team Members Contact Info
List other members participating in your team below.
1) Team Member Name
First Name
Last Name
1) Team Member Email
example@example.com
2) Team Member Name
First Name
Last Name
2) Team Member Email
example@example.com
3) Team Member Name
First Name
Last Name
3) Team Member Email
example@example.com
4) Team Member Name
First Name
Last Name
4) Team Member Email
example@example.com
Energy Stewards Information
House of Worship Facility Attributes
Year Built
Used for benchmarking energy use performance.
Gross Floor Area (sq ft)
Used for benchmarking energy use performance.
Hours of Operation for House of Worship
Used for benchmarking energy use performance.
Number of Weekdays Open
Seating Capacity of Sanctuary
Used for benchmarking energy use performance.
Number of Computers in Building
Gross Floor Area Used for Commercial Type Food Preparation (if any) (sq ft)
Used for benchmarking energy use performance.
Number of Commercial Refrigeration/ Freezer Units
For Multi-Use Houses of Worship (like buildings with schools or offices)
Use of Space & Square Ft Used
Use of Space & Square Ft Used
Use of Space & Square Ft Used
Info On Utilities Serving Your House of Worship
Utility Serving Your House of Worship
We need to know your utility provider company names and web addresses, as well as your account numbers, username and passwords. These are required for our update of monthly utility data. All login details are held confidentially by our provider and its service representative, and used only for the purpose of logging into the appropriate account, gathering the relevant monthly utility data, and logging out. If no additional data is available, we will begin with the earliest monthly data available from the utility.
Electric Company Information
Electric Company Name
Electric Company Account Number
Electric Company Web Address
Electric Company Username
Electric Company Password
Gas Company Information
Gas Company Name
Gas Company Account Number
Gas Company Web Address
Gas Company Username
Gas Company Password
Water Company Information
Water Company Name
Water Company Account Number
Water Company Web Address
Water Company Username
Water Company Password
Additional Questions
Does your building generate renewable energy?
Yes
No
If yes, if there is an additional website reporting monthly energy production, please provide web address, and log in information to access. Will allow monthly updates.
What base year have you chosen for your energy conservation calculation?
Affirmation and Signatures
Has the application been approved by your clergy?
Yes
No
Senior Lay Leader
Title & First Name
Last Name
Senior Lay Leader Email
example@example.com
Senior Lay Leader Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Senior Clergy or Staff Leader
Title & First Name
Last Name
Senior Clergy or Staff Leader Email
example@example.com
Senior Clergy or Staff Leader Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Please share any other information, complications or questions you may have.
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