  

OMB No. 2060-0347

Join the Small Business and Congregations ENERGY STAR Network

Yes, I would like to join the Network of small businesses and
congregations working with ENERGY STAR.

I believe that greater energy efficiency can increase the financial
health of my organization and aid in preserving the environment for
future generations. On behalf of my organization, I pledge to buy ENERGY
STAR equipment and upgrade the energy efficiency of my facilities
whenever financially viable. As part of the Network, I may use the
ENERGY STAR promotional mark in accordance with the ENERGY STAR identity
guidelines.

* indicates a required field.

Type of Organization *

 Small Business

 

 

 Non-Profit 

 Congregation 

Contact Information *

 

 

 

 

 

 

 

 

 

 

 

 

Your e-mail address is used only to send your “Welcome to ENERGY
STAR” package and your bi-monthly “ENERGY STAR E-Update” (6 issues
annually). Your e-mail address will not be “spammed” or sold by
ENERGY STAR.

 

 

Do you Rent or Own? *

 Rent 

 Own 

 

 

 

 

The public reporting burden for this collection of information is
estimated to average 1 minute per response.  Send comments on the
Agency's need for this information, the accuracy of the provided burden
estimates, and any suggested methods for minimizing respondent burden,
including through the use of automated collection techniques to the
Director, Collection Strategies Division, U.S. Environmental Protection
Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. 
Include the OMB control number in any correspondence.  Do not send the
completed form to this address.

EPA Form 5900-21

