Startups/SMEs' Assessment Form
Kindly take the time to fill in this form as thoroughly as possible to assess your company's eligiblity to be part of the Cluster4Green advanced circular economy training in May of 2023.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Startup/SME name
*
Brief description of the Startup/SME
*
Company Size
*
Please Select
Micro: Fewer than 10 employees
Small: 10-50 employees
Medium: 51-250 employees
Large: More than 250 employees
How long have you been in the market? (in years)
*
How familiar is your company with the concept of circular economy (1 star being “Little to no understanding” and 5 stars being “Established practice, inherent to business model”)
*
1
2
3
4
5
Self-Assessment Exercise: Select the field(s) in which circular/sustainable approaches are implemented in your company and give an example or several ones.
Energy
Applicable
Examples
Energy recovery
Energy reduce
Policy to reduce
Renewable energy
Other resources
Water
Applicable
Examples
Water treatment / reuse
Water monitoring
Water recycling
Water recovery
Chemicals
Applicable
Examples
Cleaning products
Waste Chemical storage / management
Pesticides/Herbicides
Biogas
Assets (owned/rented)
Applicable
Examples
Appliances (heating systems)
IT Equipements /Machinery
Furniture
Vehicles
Others
Buildings
*
Applicable
Example
Storage
Offices
Modular construction (energy efficient/multipurpose)
Parking / Privileged Carpooled
Demolishing sustainable techniques
Other
Food Production
Applicable
Example
Single use depletion
Plant-based diet
Local markets
Food waste/leftovers management
Packaging and Raw Materials
Applicable
Examples
Sustainable packaging
Product life cycle
Durable / reusable raw materials
Service Provider
*
Applicable
Fields of action
Guidelines
Existential facts
Proposition
Maintenance
Collection
Supply of goods
Handling
Demolishing
Rental/lease equipment
"right to repair"
Transportation
Applicable
Examples
Sustainable transportation
Delivery services
Import/export systems
Waste
Applicable
Examples
Valorize
Recycle / Upcycle / Reuse
Outsource
Additional Questions
Among the unselected categories, which one(s) would you want to work on?
*
Which performance are you seeking to enhance? (Select all applicable fields)
*
Economic
Environmental
Social
None
At which level(s) will you be implementing circular economy approaches?
Design
Procurement
Distribution
Packaging
Other
Are you available during the month of May 2023 to attend an in-person training for startups/SMEs on circular economy?
*
Yes
No
Thank you for filling the form.
You will be contacted once the selection process is completed.
Submit
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