Better Building Alliance

Organization Name:
Primary Contact
First Name:		Last Name:
Title:		Email:
Address 1:		Address 2:
City:		State:
Zip:		Phone:
Alternate Contact
First Name:		Last Name:
Title:		Email:
Address 1:		Address 2:
City:		State:
Zip:		Phone:

Member Information

Select Subgroup:

Select Subgroup:

Is your organization

For profit?
Not-for profit?

What types of buildings are in your portfolio?

Hospitals
Outpatient facilities
Medical office buildings
Other [please describe]

Are your facilities

Self-managed?
Third-party managed?
Other [please describe]

Two-year or four-year?

Two-year
Four-year
Both

Public or private?

Public
Private

Are your facilities

Self-managed?
Third-party managed?
Other [please describe]

Building Portfolio

Number of buildings in your portfolio: Include managed and franchised space, if applicable.
Total square footage of portfolio:
Percentage of portfolio that is third-party managed:
Percentage of portfolio that is franchised:

Energy Considerations

Do you track the energy use of your buildings via tools such as Portfolio Manager?

Yes
No

What are your organization-wide energy-savings goals? [For example, portfolio-wide savings of 10% over 2010 baseline; annual EUI improvement goals; Portfolio Manager score targets] If you do not yet have organization-wide energy savings targets, please explain any future plans to set such goals.
What are the primary challenges you currently face in meeting your goals?
Alliance partners are encouraged to share strategies for success. Have you overcome any efficiency barriers that you believe other Alliance partners face? If yes, please describe. If you have additional information/files you would like to send, please attach and send in an email to BBA@ee.doe.gov.

Partners are encouraged to participate in at least one Solutions Team.
If you are interested, please indicate your choice(s) below.

Market Solutions
Building Envelope
Lighting & Electrical
Space Conditioning
Refrigeration
Plug & Process Loads
Energy Management Information Systems
Renewables Integration

May we use your company logo on posters and other printed material for reports and presentations?	Yes No
If we have permission to use your logo, please provide contact information for someone who can provide a high-resolution (300 dpi) version of logo.

As an authorized representative of my organization, I agree to the Terms set forth above and request to join the Alliance.

Authorized Company Representative:

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Better Buildings Alliance Sign-Up Form

Member Information

Building Portfolio

Energy Considerations