APPLICATION TO JOIN THE ENERGY EFFICIENCY NATIONAL PARTNERSHIP Date: Click here to enter date (e.g. 12 Dec 14) To: Director Energy Efficiency and Conservation Department National Environment Agency Email: NEA_EENP_SECRETARIAT@nea.gov.sg Attn: EENP Secretariat Our company, Click here to enter name of company, is interested in becoming a Partner of the Energy Efficiency National Partnership. As a Partner of the Energy Efficiency National Partnership, we commit to continuously improving our energy performance. We will: 1) Work towards adopting in-house energy management systems. This will involve a) b) c) d) Appointing an energy manager; Developing an energy policy; Establishing energy targets; and Implementing energy efficiency improvement plans. 2) Participate in EENP Learning Events and 3) Share our energy efficiency success stories. Details of our current energy management practices are provided in the Annex. Our designated contact persons are indicated below. Please liaise with them to formalise our partnership. Main Contact Person Alternative Contact Person Name: Designation: Email: DID: UEN No.: Address: Website: Yours faithfully, _______________________ Click here to enter name. Click here to enter senior management designation (e.g. CEO, MD) For and on behalf of Click here to enter name of company. 1 of 3 Updated on 4 November 2015 APPLICATION TO JOIN THE ENERGY EFFICIENCY NATIONAL PARTNERSHIP Annex: Company’s Information Company’s Primary Business or Function (please check one): Is your company considered a small and medium-sized enterprise (i.e. a business with annual sales turnover of not more than $100 million or employing no more than 200 staff)? Yes No Information on my company’s energy management: 1a. Does your company have an energy policy? Yes No If yes, please share your company’s energy policy. If no, please share your company’s upcoming plans in this area, if any: 1b. Does your company have an energy improvement target? Yes No If yes, please share your company’s energy improvement target. If no, please share your company’s upcoming plan in this area, if any: 2 Does your company have an energy manager or a team looking into improving energy performance within the company? Yes, an energy manager. The energy manager is SCEM Certified Not SCEM Certified Yes, an energy/environment team has at least one certified SCEM does not have any certified SCEMs No. Please share your company’s upcoming plans to have an energy manager/environment team: 2 of 3 Updated on 4 November 2015 APPLICATION TO JOIN THE ENERGY EFFICIENCY NATIONAL PARTNERSHIP 3 Has your company undertaken any projects to improve on energy efficiency? If so, please share an example of such projects. If not, please share your company’s upcoming plans in this area, if any. 4 Does your company monitor its energy usage? Yes Monitor through monthly energy bills Energy Management System, please elaborate: Others: No, please share your company’s upcoming plans in this area, if any: 5 What is your company’s average energy usage (in GWh and/or TJ per year)? * Please rest assured that the information provided will be kept confidential. 3 of 3 Updated on 4 November 2015