Michigan Great Printers Project
Registration Form

Printer Name: *

Contact Person: *
Number of Employees:  *   County:*  

Address: *

City: *

State: *

Zip: *

Phone: *

Fax:

E-mail Address:  

Internet Address: 

Our company is committed to the following three pollution prevention strategies as described in the MICHIGAN GREAT PRINTERS PROJECT Pollution Prevention Checklist and Strategies (pp. 4-8) (please list pollution prevention goals):

 

Goal #1*

Goal #2*
 

Goal #3*

Our company is a member of (please list any Michigan Professional, Business, or Trade associations/organizations to which you belong):

Our company partners with the Michigan Department of Quality (please list partnerships that you belong to or are active in):

Please indicate your interest in the following materials:

MI-GPP Information Sample Environmental Policies
MDEQ-EAD publications list             RETAP information
Small Business Pollution Prevention Loan Program information

Use of this form indicates that you agree to be a partner in the Michigan Great Printers Project (MI-GPP) and commit to undertake voluntary pollution prevention (P2) in your daily operation. By doing so, you commit to three pollution prevention goals, to be reported on bi-annually, as well as establishing an Environmental Policy for your company.

Authorizing Official:  *
Title:  *