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Greenopia Questionnaire - Restaurants Copy

Welcome to Greenopia! We're thrilled that you are applying to join our network. Please fill in this questionnaire, which has some fairly detailed questions about your products, services and general practices. The questions fall into 3 sections: Healthy for You, Healthy for the Planet and Healthy for the Community. If you qualify we will onboard you onto our system, send you a window decal and include you in our listings. If you do not, our relationship doesn't end here! If you wish to try again we can let you know which areas to focus on based on your responses.

Name of Business

Business Location Address

Website

Email Address

Phone Number

Describe your business in a few sentences

Upload your logo here

Is your business a certified B Corp?

Upload any photos of your business that you would like to feature

Are at least 50% of all of your “to go” containers and carryout bags Biodegradable and/or made from Recyclable Material and/or Chlorine-Free Paper?

Yes
No
Don't Know

Do you have delivery/service vehicles that operate on Alternative Fuels (Biofuels), hybrid, or electric engines?

Yes
No
Don't Know

Are your Advertising or Promotional Materials made from Recycled Materials?

Yes
No
Don't Know

Do you participate in a Biodiesel Recycling program?

Yes
No
Don't Know

What percentage of your waste does your restaurant recycle?

Less than 25%
25%
50%
75%
At least 90%

What percentage of your seafood is: certified MSC/ASC or on the Seafood Watch list as either a best choice or good alternative?

Less than 25%
25%
50%
75%
At least 90%
n/a

Are you a part of sustainability association/program in your city, e.g. by the government or an NGO?

Yes
No
Don't Know

What other sustainability associations/programs are you a part of?

Are all or most of your cleaning products environment-friendly (e.g. biodegradable, non-toxic, green production)?

Yes
No
Don't Know

Are most of your appliances Energy Star certified?

Yes
No
Don't Know

Does your business utilize Low Flow Water fixtures?

Yes
No
Don't Know

Does a significant portion of your power (>20%) come from Renewable Resources such as wind, geothermal, small hydro, biomass, or solar?

Yes
No
Don't Know

What percentage of your total produce purchased is locally grown (within 250 miles)?

Less than 25%
25%
50%
75%
At least 90%
n/a

Do you Compost or participate in a Composting Program?

Yes
No
Don't Know

Does your business have any accredited certifications related to health?

If so, what are they?

If applicable, briefly describe your building's green design or construction (10 words max):

For each of the following food types that you might serve in your establishment, please estimate what percentage is certified organic (if you don't offer that food, select n/a):
	Less than 25%	25%	50%	75%	At least 90%	n/a
Produce
Dairy
Non-dairy beverages Coffee, tea, alcohol, juice, soft drinks, etc)
Grain
Meat
Poultry & Eggs

In your business, approximately what percentage of the jobs created offer regular, predictable hours?

None
25%
50%
75%
All
Don't Know

In your business, approximately what percentage of the jobs created offer paid vacation, sick and leave time?

None
25%
50%
75%
All
Don't Know

Do you have any specific project designed with or targeted to benefit under-represented groups or communities?

Yes
No
Don't Know

Does your business have a policy or program for donating edible surplus food?

Yes
No
Don't Know

In your business, approximately what percentage of the jobs created offer a payment above the minimum-wage of your State?

None
25%
50%
75%
All
Don't Know

Do you take steps in ensuring fair hiring practices?

Yes
No
Don't Know

Does your business donate a percentage of profits to a charitable cause?

Yes
No
Don't Know

Does your business have disability access?

Yes
No
Don't Know

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