Breastfeeding Family-Friendly Employers and Community Partners

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Email *

Business/Organization Name

Point of Contact Name

Point of Contact 10-Digit Phone Number

Business Street Address

City

Zip

Business website/URL

Number of Employees

1-10

11-20

21-50

51-100

101-200

201-300

300+

Hourly Employees

Salaried Employees

Per Diem Employees

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The Community Partner award is for organizations that support chestfeeding/breastfeeding customers or patrons.

The Employer Award is for businesses that support lactating staff members.

Organizations/Businesses may apply for both or just one. Please select all that apply for your business.

We are applying for the Community Partner Award only.

We are applying for the Employer Award only.

We are applying for both awards.

For the Community Partner (for supporting chestfeeding/breastfeeding customers or patrons), please select all supportive practices that apply:

Required for Award: We do not advertise infant formula or related products directly to consumers.

Required for Award: Breastfeeding/chestfeeding families are always welcome and respected. They will never be treated poorly, asked to stop feeding, or asked to cover up or move.

Required for Award: We support all breastfeeding, chestfeeding, and human milk feeding families inclusive of their race, ethnicity, immigration status, nationality, creed, age, sexual orientation, gender identity, family structure, primary language, ability, or class.

We would like to display a "Breastfeeding Welcome Here" window cling from NCBC.

Optional/Recommended: Customers/Patrons have access to a private space for expressing milk or nursing, if desired. The space is NOT a bathroom, and is lockable and shielded from public view.

Optional/Recommended: We have a written lactation support policy, and orient our staff to its principles to ensure appropriate treatment of families.

Optional/Recommended: Our staff are educated on the rights and needs of chestfeeding/breastfeeding families.

Optional/Recommended: We offer print materials for local lactation support resources for our customers.

Optional/Recommended: We display lactation promotion materials.

We are only applying for the Employers Award.

Other:

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