Sustainable Business Coalition member form
Welcome to the Sustainable Business Coalition! This form will take 10-15 minutes to complete.
Business name
First and last name of the point person
Email
Phone number
Our business supports the Vision and Mission
Vision: We envision a future where every workplace enhances environmental and social conditions. Mission: We are a group of Harrisonburg-Rockingham County businesses focused on reducing carbon emissions while modeling the economic sense in energy efficiency, increased local renewable energy, and incorporation of best sustainability practices.
Agree
Disagree
Other:
Diversity
We actively strive to create a diverse coalition that, at minimum, reflects the diversity of our city. Building a diverse coalition will strengthen the impact of the coalition. The following 4 questions will give us the data we need to measure our progress.
Gender
Female
Male
Non-binary/third gender
Prefer not to say
Other:
Race/ethnic identity
Industry type
Using the NAICS classification system
Choose
Agriculture, Forestry, Fishing and Hunting
Mining, Quarrying, and Oil and Gas Extraction
Utilities
Construction
Manufacturing
Wholesale Trade
Retail Trade
Transportation and Warehousing
Information
Finance and Insurance
Real Estate and Rental and Leasing
Professional, Scientific, and Technical Services
Management of Companies and Enterprises
Administrative and Support and Waste Management and Remediation Services
Educational Services
Health Care and Social Assistance
Arts, Entertainment, and Recreation
Accommodation and Food Services
Public Administration
Non-profit
Other
Business size
Are you classified as a small business by the Small Business Association?
Yes
No
Non-profit
Unsure? Use this tool to find out:
sba.gov/size-standards/
Other:
The Map
We put our members on the map! The following questions and request for pictures will tell residents and other businesses more about you.
3 Successes
What has your business already done to improve environmental, social and/or economic sustainability? Need ideas? Look at the B-corp best practice guides (
https://b-lab.uservoice.com/knowledgebase/topics/137269-best-practice-guides
) or the VA Green "Full Certification Application" (
https://www.virginiagreen.net/s/2-21-18-Full-Application-jb5l.docx
). An example might be that you have a supplier code of conduct which include labor standards and practice, environmental policy, and documentation and review Policy.
3 Business goals
What do you hope your business will be doing or implementing in the next few years related to advancing environmental, social and/or economic sustainability in our community and beyond?
Pictures
Upload up to 3 pictures that will go on the map. We recommend a picture of your business from the outside and pictures that show your achievements related to sustainability.
Add file
Picture descriptions
Provide us some descriptions for your pictures so people understand what is happening.
Next Steps
Thanks for staying with us! We are excited to have you on the Coalition.
1. Energy audit and energy tracking
We like our members to get a free energy audit and track their energy usage year to year using a free program called Energy Star Portfolio Manager. This gives us a measure of emissions and costs associated with energy use for the coalition at large. It takes 90 minutes to set up your account and record your baseline data. After that it may take 15 minutes a year to update your energy use. If you prefer we do not help you schedule a time for both the audit and the tracking please indicate it in the comment section.
2. Attend and host quarterly meetings or panel discussions over lunch
The Sustainable Business Coalition meets quarterly in a collaborative and educational fashion. Our members take turns hosting which includes providing snacks or a light lunch. Renew Rocktown takes care of the facilitation and coordination. If you are not able to host please let us know in the comment section. Details about dates and locations will reach you through your email and can be found at
http://renewrocktown.org/harrisonburg-sustainable-business-coalition/
3. Free triple bottom line assessment equipped with best practices and real examples of what other businesses are doing.
We highly encourage our members to spend 90 minutes on the B-corp assessment. The assessment is free and if one wishes to get certified there would be a sliding scale fee. If you do not want us to schedule a time with you to start the b-corp assessment please indicate it in the comment section.
Comments & Questions
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