What is the workplace location that you are assessing?

How many employees use this location?

Does your workplace have an environment, climate, or sustainability policy, or a group of workers who form a sustainability committee? Please select Yes No

If yes, please briefly describe:

Is your workplace electricity supplied by 100% Greenpower? Please select Yes No

Are all computers shut down (not to standby or hibernate!) overnight? Please select Yes No

Are all computer monitors also switched off overnight? Please select Yes No

Are computer monitors switched off (not just screensaver) when workers leave their desks? Please select Yes No

Do office printers have a power save mode when not in active use? Please select Yes No

Are printers switched off overnight? Please select Yes No

What percentage of lights in your workplace are energy-efficient fluorescent bulbs or tubes? Please select None 1-20% 21-40% 41-60% 61-80% 81-100%

Are separate areas of your workplace lit by lights on separate switches, or must a whole floor be lit even if only one person is at work? Please select Separate switches Whole floor switches only

For occasionally used areas of the workplace, such as kitchenettes and bathrooms, are lights turned off when these areas are not in use? Please select Yes No

If your workplace has air conditioning, at what temperature is it set?

Does your workplace kitchenette use an individual kettle instead of a constantly_boiling urn? Please select Individual kettle Urn

If yes your workplace has air conditioning, a hot water urn, cold drink dispensers or vending machines, do these use timer switches, which automatically switch off overnight? Please select Yes No

Are appliances which are only occasionally used, such as microwaves, kettles, coffee machines and document shredders routinely turned off at the wall? Please select Yes No

Does your workplace have a well-known paper usage reduction policy or similar in place? Please select Yes No

Do the printers in your workplace print on both sides of the paper as default? Please select Yes No

Does your workplace print on 100% post-consumer recycled paper? Please select Yes No

Are unwanted one-sided printouts re-used for further printing or as notebooks? Please select Yes No

Does your workplace have paper recycling bins easily accessible to all workers? Please select Yes No

Approximately what percentage of paper waste in the workplace is recycled? Please select None 01-20% 21-40% 41-60% 61-80% 81-100%

Does your workplace have recycling bins for non-paper recyclables, such as milk cartons, easily accessible to all workers? Please select Yes No

Does your workplace have washable mugs/cups and crockery available for workers to use? Please select Yes No

Does your workplace have reuseable bags available for trips to get office supplies, groceries or lunches? Please select Yes No

Do most of your workmates take a re-useable mug to and from work for their take-away coffee? Please select Yes No

Does your workplace have a system for recycling of printer toner cartridges? Please select Yes No

Does your workplace have dual-flush, water efficient toilets? Please select Yes No

Does your workplace have water-efficient devices fitted to taps in bathrooms and kitchenettes? Please select Yes No

Does your workplace have a well-known water management or conservation protocol in place? Please select Yes No

If your workplace has a fleet of company cars, what percentage of the car fleet are efficient or hybrid vehicles? Please select None 01-20% 21-40% 41-60% 61-80% 81-100%

What percentage of your workmates take public and/or active transport (walking, cycling, skateboarding) to work each day? Please select None 01-20% 21-40% 41-60% 61-80% 81-100%

Does your workplace have a car-pooling policy? Please select Yes No

Does your employer buy carbon offsets for all employee flights? Please select Yes No

Does your workplace have bicycle/shower/change room facilities? Please select Yes No

If you have any other suggestions or comments about the environmental and energy practices of your workplace, please let us know here:

Your name:

Email:

Contact phone number (mobile preferred):

QPSU Membership Number:

Work area:

Job title:

Do you wish to be added to the QPSU update list? Please select I am already a member Yes No