Circular Economy Accelerator Program

CIRCULAR ECONOMY ACCELERATOR - Business Intake Form

Thank you for your interest in participating in the Circular Economy Accelerator Program. This intake form will help our team determine your eligibility for participation. Please submit questions to projectzero@synergyfoundation.ca
APPLICANT INFORMATION
Organization Name*
Sector*
Organization Size (# of FTEs)*
ORGANIZATION INFORMATION
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Website*
Years in Operation*
Is the company majority owned by any of the following underrepresented communities? Please select all that apply.*

IndigenousWomenLGTBQ+BIPOCNewcomer to CanadaNone of the aboveChoose not to disclose
Has your business completed a waste audit in the past?*

YesNo
Has your business completed an energy audit in the past?*

YesNo
If you answered "Yes" to completing a waste audit and/or energy audit, are you able to provide the data?

YesNo
How familiar is your organization with the concept of a circular economy?*

1

2

3

4

5

1 is Brand new concept, 5 is Part of our everyday operations
Has your organization participated in any circular economy programs before?*

YesNo
If you answered "Yes" to previous participation in circular economy programs, please provide name of program(s).
POINT OF CONTACT
First and Last Name*

First NameLast Name
Position/Title*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
PROJECT INFORMATION
Describe your business and its main operations*
What is your business' primary product and/or service?*
List the problematic/challenging waste streams that you have identified.*
Select the core areas of circularity you are hoping to focus on (select all that apply)*

Energy RecoveryWaste Management & DiversionWaste PreventionSustainable PurchasingMaterial ReuseOther
What source of energy and utility do you use on-site? (select all that apply)*

BC HydroNatural GasDiesel GeneratorBiomassSolarWindMunicipal WaterWell WaterGasolineDieselBiodieselOther
What are you hoping to gain from this program?*
What is the best month to conduct your site assessment?*
Site assessments must occur by March 2026.
How did you hear about this program?*
Terms of Participation

1. Permission to recognize the name of your company as a participant in the program (in final report, social media, press releases, presentations etc.)

2. Permission to include aggregate data from your assessment in the final report for this program

3. Permission to share the findings from your final report with program funders

4. Confirms that the business holds all necessary licenses, permits, and is fully compliant with local regulations.
Do you agree to the Terms of Participation outlined above?*

YesNo
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CIRCULAR ECONOMY ACCELERATOR - Business Intake Form

APPLICANT INFORMATION

ORGANIZATION INFORMATION

POINT OF CONTACT

PROJECT INFORMATION

Terms of Participation