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Accurately measure and manage your organisation’s energy use and efficiency.
Energy-Mark certification application form
1. Organisation details
Registered Company Name
2. Primary contact details
Please use numbers only, no spaces or other characters
3. Core Business activities
(a general description of your organisation)
4. Number of employees
5. Number of sites/facilities
6. Annual revenue in NZ$M
(if greater than 100$M, say 'greater than 100$M')
7. Please supply an estimate of your energy use for a 12 month period for the following
Annual Energy Budget ($)
Electricity (approx. % of spend)
Petrol (approx. % of spend)
Diesel (approx. % of spend)
Natural Gas (approx. % of spend)
LPG (approx. % of spend)
Other (approx. % of spend)
8. Does your company have an employee with energy management responsibility?
9. Has your company had an energy audit in the past?
10. Is energy currently monitored and reported?
11. Do you currently use a building management system?
12. Do you currently use energy management software?
(Energy Pro, E-Bench, Elleserve, etc.) if so, which software?
13. In which sector do you operate?
14. What current environmental or management system certifications do you have (if any)?
15. Please tick significant energy users within the organisation?