1-Star Application

EMGS Renewal Application

Energy Management Gold Standard
Assessment Level

Star Rating
Assessment Level 2
Site Name
(Example: Malaysian Green Technology and Climate Change Corporation)
Type of Location
Type of Area Assessed
(Example: Healthcare Facilities- Minor Specialist, Major Specialist, General, District or Special Institute, Education Facilities, Office Building, Laboratory, Data Centre, Others)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Director/President/CEO/MD Name

First NameLast Name
Director/President/CEO/MD Email
example@example.com
CEM Name

First NameLast Name
CEM Registration No.
CEM Email
example@example.com
CEM Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organization Representative Name

First NameLast Name
Organization Representative Email
example@example.com
Organization Representative Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have your organization been registered or certified for any standard or system?
(Example: ISO50001, OHSAS, etc.)
Monthly Energy Consumption (kWh)
Please state the baseline you employed for energy performance measurement
Please state year & total energy consumption (kWh) for baseline.
Please state annualized energy consumption for current year
Please state year & annualized energy consumption (kWh)
Energy performance/Saving declared during previous assessment (%)
(% of energy saving achieved during previous assessment)
Current energy performance/Saving compared to baseline (%)
(% of current energy saving compared to baseline)
EMGS Preparation Checklist for Renewal

(Refer checklist 1-Star/2-Star/3-Star)
Cancelof
Data Form for Applicants

Cancelof
When would you recommend the date of the assessment?

DayMonthYear
Start Date
Remarks
Note: Please specify if there any additional factors influences energy performance (Example: static factors, etc.)
Should be Empty:

EMGS Renewal Application