GreenGain Program Application - Cohort 2

GreenGain Program Application - Cohort 2

Hello,

Thank you for your interest in participating in the GreenGain Sustainability Training Program for small Connecticut manufacturers!

We are excited to offer training, funding and corporate mentorship designed to help small manufacturers in Connecticut decrease costs and increase competitive advantage.

The application should take 5-10 minutes to complete. There is a $175 application fee that is reimbursed on completion of the training.

If you have questions about the program contact hburns@ctsbcouncil.org.

If you experience any technical issues with the application, contact admin@ctsbcouncil.org.

Company Information
Company Name*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Contact Person*

First NameLast Name
Title*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Year Founded*
Number of Connecticut-Based Employees*
Number of Facilities in CT*
Number of Facilities Located Outside of CT*
Does your company own or lease your property?*
Annual Revenue*
How did you hear about the GreenGain Program? *

Company Profile
Industry and Type of Manufacturing (NAICS)*
Describe your business. What products or services do you provide? Who are your customers?*

Sustainability Practices and Goals
YesNo
Describe your current sustainability practices, if any:*
What are your sustainability goals for the next 1-3 years?*
YesNo
YesNo
YesNo
Details of previous sustainability training program participation:*

Challenges and Needs
What are the challenges your company faces in implementing sustainability?*
StrategyReportingCertification(s)Energy EfficiencyRenewable EnergyFinancing/IncentivesOther
Other
Describe any barriers to implementing sustainability practices in your company:*

Environmental Impacts Assessment

Describe your facility's challenges and goals related to environmental impacts.
YesNo
YesNo
Does your facility discharge wastewater as part of its operations?*
Examples: cooling, rinsing, cleaning, or processing activities
Approximately how many gallons of wastewater does your facility discharge per day?*
High water purchasing costsHigh wastewater disposal or hauling costsDifficulty meeting discharge permit requirementsEnvironmental compliance concernsNone of the above
Would you be interested in learning about sustainable technologies that can help you reduce or capture CO2, recycle wastewater and/or reduce costs?*

Financial and Logistical Considerations
YesNo
YesNo
How much is the budget for sustainability initiatives?*

Agreement
Should be Empty: