HCCC C&GW Clean Business Award Nomination Form
Workplace Name
Address (Must be located within Hampton city limits)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Workplace
Workplace Contact Person
First Name
Last Name
Workplace Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Workplace Contact Email
example@example.com
Nominator Name
First Name
Last Name
Nominator Email
example@example.com
Clean & Green Workplaces Qualities: Please Check All That Apply!
Litter-free efforts apparent
Attractive premises
Contributions to community
Recycling and/or waste reduction efforts
Trash and ash receptacles
Urban forestry and tree stewardship
Sustainable landscaped areas
Energy conservation practices
Water conservation practices
Heritage preservation
Overall impressions of workplace
Other
Brief Explanation of Why This Business Should Win A Clean & Green Workplace Award:
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