Go Green Community Application Form

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* Required fields
I understand that my completed application will be submitted to the City of Houston for final approval. I assert that all statements made in this application are true. I understand that if I am found to violate any of the requirements for participation in this program, my "Go Green Community" status may be revoked. I further certify that I own the property that is registering for this program, or I am acting as an agent of the owner in doing so.*

Yes, I agree
Applicant:

Name of individual filling out form *

Relation of individual to property *

Email *

Owner/ Management Info:

Owner Name

Management company name (If applicable)

Property Information:

Community/property name *	Manager name *	Phone number * ### - ### - ####
Number of units on property *	Approx number of occupied units *	Approx rental price per s/f

Street address *
City	State	Postal / zip code

Mailing address (If different from property address)

Street address
City	State	Postal / zip code

Current Waste Hauler:

Current waste hauler company*

Name of waste hauler representative *

Recycling Partner:

Recycling hauler company

Name of recycling hauler representative

Doorstep-style trash/recycling company (if applicable)

Program History:

When did your recycling program begin at your community? *

MM / DD / YYYY

Education:

What methods does your property use to educate renters about your recycling program?

1. Are signs displayed describing the recycling program for renters? *

Yes

2. Are renters provided with information about the recycling services upon move-in and/or rent renewal? *

Yes

3. Are periodic reminders provided to renters about the program (i.e. announcements, education events, flyers, etc)? *

Yes

Collection:

What method does your property use to collect recyclables from renters?

4. Do you have a doorstep-style recycling collection bin from each unit? *

Yes

If yes, how frequently is recycling collected?

once a week

2-3 times a week

4-5 times a week

6-7 times a week

5. Do you have one or more centralized collection points for recyclables on your property? *

Yes

If yes, how many recycling collection points do you have on your property?

If yes, where are the recycling collection points located? (less than 250 words)

If yes, are recycling containers located at every trash container?

Yes

6. Are recyclable materials collected by a contracted waste or recycling hauler? *

Yes

If yes, how often are recyclables collected by the hauler?

once a month

twice a month

once a week

2-3 times a week

4-7 times a week

If yes, what size of container/dumpster is used for collection of recyclables?

Recyclable Materials:

How are the following materials disposed of? (Select all that apply)

Aluminum and steel containers: * Waste hauler Recycling hauler Self haul Not included	Plastics: * Waste hauler Recycling hauler Self haul Not included	Glass: * Waste hauler Recycling hauler Self haul Not included	Cardboard: * Waste hauler Recycling hauler Self haul Not included
Mixed paper (newspaper, junk mail, cardboard, phonebooks, magazines, computer paper): * Waste hauler Recycling hauler Self haul Not included

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Applicant:

Owner/ Management Info:

Property Information:

Current Waste Hauler:

Recycling Partner:

Program History:

Education:

Collection:

Recyclable Materials: