DC/Maryland Breastfeeding-Friendly Workplace Recognition Awards
Nomination/Site Inspection Form 2021
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Email *
Business Name *
Business Address: *
Nominator (first and last name) *
Contact Person (Office Manager or Human Resource Manager) *
Contact Person E-mail Address *
Phone Number *
Size of Business *
Check all criteria that you can verify:
Businesses will be recognized as follows:
Small (up to 50 employees): Bronze: 4-12 points, Silver 13-24 points, Gold ≥ 25 points (at least 1 gold criteria must be met)

Medium (50-500 employees): Bronze: 8-18 points, Silver 19-35 points (at least 1 silver criteria in 2 categories must be met), Gold ≥ 36 points (at least 2 gold criteria must be met)

Large (500+ employees): Bronze: 12-24 points, Silver 25-49 points (at least 1 silver criteria in each category must be met), Gold ≥ 50 points (at least 4 gold criteria from at least 2 different categories must be met)
Bronze (1 Point each)
Silver (2 Points each)
Gold (3 Points each)
Please feel free to share any additional details about your breastfeeding supports.
A copy of your responses will be emailed to the address you provided.
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