Michigan Business Pollution Prevention Partnership
Registration Form

FOSTERING VOLUNTARY POLLUTION PREVENTION IN THE BUSINESS COMMUNITY


Please print this page for your records.
 

Business Name: 
Business Type: 
S.I.C. Code:    Number of Employees: 
Single Facility  --  Corporation-all Michigan facilities
Contact Person: 
Address:
City: 
Phone:     Fax:
E-mail:  
Website: 
County:   State:     Zip: 

Please list your environmental goal(s).*

List any Michigan Professional, Business, or Trade associations/organizations as well as other partnerships to which you belong:

Are you currently ...

Reducing wastes   Reusing wastes  Recycling wastes

Please indicate your interest in the following materials:

P2 information to help set goals Example P2 policies
MDEQ-ESSD publications list        RETAP information
Environmentally Preferred Purchasing information  P2 Loan information

Use of this form indicates that you agree to be a partner in the Michigan Business Pollution Prevention Partnership (MBP3) and commit to undertake voluntary pollution prevention (P2) in your daily operations.  You further agree to provide waste prevention and reduction goals, an annual progress summary, and to share success stories on pollution prevention opportunities.

Authorizing Official: 
Title: 

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