Climate Rehab - Free Certification for Climate Positive Organisations and Individuals

Climate Rehab Certification Application
Applicant: *
Type of Application: *
specify if other:
Contact Name: *
E-mail: *
Phone:
Skype:
Address:
Town/City:
Post/Zip Code: *
Country: *
Activities
What are the main activities of your organisation? (individuals leave blank):
....
Please describe the activities you are taking to reduce your greenhouse gas emissions:
....
Please outline what activities you are taking to remove and offset greenhouse gases from the atmosphere:
....

Predicted Greenhouse Gas Emissions
(tonnes CO2 equivalent for 12 months following application date)
A. Predicted Emissions:
B. Predicted emissions removed and offset:
C. Total predicted emission reduction (B-A):
Note: For individuals, emissions must account for all household energy consumption (individual share) and travel (including public transport). For organisations, emissions must account for all energy consumption at premises (including rented property), all company vehicle emissions, emissions from staff business travel and any other activities or processes that cause the emission of greenhouse gases. Other entities such as products or buildings must account for the embodied energy, as well as any packaging, distribution and emissions during use.
Terms & Conditions
Climate Rehab retains the right to use any information provided on this form in its promotion and in ensuring the transparency of the certification scheme.
If granted the Climate Rehab certification, the applicant must be committed to removing or offseting at least 10% more greenhouse gas emissions (CO2 tonnes equivalent) than are emitted by his/her/its activities for a period of 12months from the application date AND making a net reduction in atmospheric greenhouse gas emissions of at least 1 tonne CO2 equivalent within this period.
The applicant must adhere to any communication guidelines provided by Climate Rehab.
Climate Rehab reserve the right to refuse applications for any reason.
Climate Rehab reserves the right to withdraw certification from applicants at any time if it believes that the applicant is not complying with the terms and conditions of the agreement or is acting in any way that might damage the Climate Rehab name.
Agreement
I agree that this application has been completed accurately and in full to the best of my knowledge and that if at any time the details of this application change then I will inform Climate Rehab immediately in writing. I understand and agree to all terms and conditions set out in this application and guarantee that I have the authority to submit this application on behalf of the applicant.
Do you agree? *	Yes No