New Jersey Breastfeeding-Friendly Worksite Recognition Program
On-Line Self-Assessment/Application
Workplace Name *
Workplace Mailing Address *
Website URL
Point of Contact Name *
Point of Contact email *
Point of Contact phone *
Number of Employees
Select all supportive practices that apply
Your application will not be considered complete until you have sent a photo image of your lactation space to NJBreastfeedingCoalition@gmail.com
Does the NJBC have permission to publish your workplace location and photos of your lactation space on our website, once your submission has been approved?
I certify that the above criteria listed in this application for worksite recognition have been in effect for at least 6 months.
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