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Contact Name (required)

Contact Position


Contact Phone (required)

Contact Email (required)

(This information is confidential)

Business Name

Number of physical locations within King Co.


Business Phone

Business Email


Business Category

(The information above will be used to promote your business)

Membership type you are applying for:
 Green Greener Greenest

Are you privately held?
 Yes No

Does your business have any physical locations outside of King County?
 Yes No

If yes, please list all...

Does your business have a parent company located outside of King County?
 Yes No

Is your business affiliated with any national organizations?
 Yes No

If yes, please explain....

Is at least 51% of your ownership located within King County?
 Yes No

Are at least 75% of your employees physically located within King County?
 Yes No

Is your business currently registered to operate with the city of Seattle?
 Yes No

Does your business make a conscious effort to support local businesses in any way possible and source supplies locally for your company whenever possible?
 Yes No

Does your business appreciate the true economic, community, environmental, and personal advantages associated with supporting local businesses?
 Yes No

Briefly describe what products you sell or what services you offer. (Used as key words for online directory)

Signature (required)