Apply Now

Applicant Information

Company Name *

Address Line 1 *

Address 2

City *

State/Province *

Zip/Postal Code *

Country *

Main Contact *

Email *

Phone *

Website

Are you a member of the Brooklyn Chamber of Commerce * Yes No

What is the legal entity of your business? * Sole Proprietor LLC C-Corp S-Corp B-Corp Partnership Other

For the most recent full year, what was your business's annual gross revenue? * Less than $50,000 50,001 - 150,000 150,001 - 300,000 300,001 - 500,000 500,001 - 1MM 1MM - 3MM 3MM or more Other

Product Information

Please describe your product(s) in detail *Note - certification will apply to entire product line, If seeking certification for more than one product line, please complete a separate application.

What percentage of ingredients/raw materials are sourced from Brooklyn? *Ingredients/raw materials are the components used in the making of your product 0 - 25% 26 - 50% 51 - 100%

What percentage of ingredients/raw materials are sourced from New York State? * 0 - 25% 26 - 50% 51 - 100%

How much product research, design, and development takes place in Brooklyn? * 0 - 50% 51 - 100%

Please indicate how much processing of raw materials, associated with your product(s), takes place in Brooklyn *The processing of raw materials is defined as the transformation, cleaning, or modification of materials into usable inputs. 0 - 24% 25 - 70% 71 - 100%

Please indicate the extent to which product assembly takes place in Brooklyn * 0 - 24% 25 - 70% 71 - 100%

Please indicate how much of your product's finishing processes take place in Brooklyn *Product finishing is defined as the packaging, quality control, and final stage touch-ups for each product. 0 - 24% 25 - 70% 71 - 100%

Community Information

Number of full-time employees * 0 - 5 6 - 10 11 - 15 16 - 25 26 - 50 51 - 100 100 or more

Number of part-time employees * 0 - 5 6 - 10 11 - 15 16 - 25 26 - 50 51 - 100 100 or more

Share of Production Employees in Brooklyn *The share of total employees located in Brooklyn is defined as the number of employees stationed in Brooklyn facilities divided by the total number of employees in all facilities. For example, if your company has a main office in Manhattan, but a production facility in Brooklyn, you would indicate the share of total employees working only at the Brooklyn facility. This question refers only to employees involved in the production process. Please indicate the share of your firm's production employees stationed in Brooklyn: 0 - 50% 51 - 75% 76 - 100%

What percentage of your employees are Brooklyn residents? * 0 - 50% 51 - 75% 76 - 100%

Does your business participate in charitable activities in Brooklyn? * Yes No

Business Information

Are one or more of your company's senior managers (CEO, COO, CFO, etc.) stationed in Brooklyn? * Yes No

Was your company legally incorporated with a Brooklyn address? * Yes No

Please indicate how long your business has been continuously operating in Brooklyn * 0-2 2-5 5 or more years

Does your business participate in any of the following programs? Please check all that apply Pratt Center's Made in NYC Program B Corporation Status Fair Trade Certification Any Organic Certification Kosher Certification Vegan Certification Other

Signature

Please sign below *Certification status is subject to verification by annual audit of randomly selected participants. By signing this application, I certify that the above facts are true to the best of my knowledge and belief. I understand that failure to provide accurate information shall disqualify my business from obtaining certification status for a period of one (1) year.

Date *