2. Pledge Form for Businesses
4. Pledge to be #PurelyJupiter
   Single-use plastics are harmful to Jupiter’s oceans, waterways, natural areas and wildlife. I will do my part to reduce or eliminate my use of plastic straws and will work towards an overall reduction in my use of single-use plastics.
6. As a business, I will do one of the following to help accomplish this goal:

   1. Providing straws only upon request
   2. Providing environmental-friendly straws
   3. Eliminating the option for straws (unless physically necessary)
8. Furthermore, I will go beyond the straw to proactively seek ways to reduce my business’ use of single-use plastics.
   
   Sign the Pledge
   *We will use the business name and website you provide to promote you on our webpage as a PURE participant.
10. Business Name*
12. What Kind of Business?*

    1. Restaurant or Bar

    1. Hotel

    1. Venue

    1. Other
14. Briefly Describe your Business
16. Primary Email Address*
17. Website*
19. Address
21. City
22. State
23. Zip
25. Phone Number*
26. Point of Contact*
28. How did you learn about our pledge campaign?
30. As a business we agree by checking this box to reduce our straw consumption in one of the following methods listed above.*

    1. I pledge to be #PurelyJupiter
32. Florida has a very broad public records law. Under Florida law, e-mail addresses are public records. The Town makes every effort to protect individual privacy, but may be compelled to provide email addresses in some circumstances under Florida law. If you do not wish to provide your email when signing up for this program, please call Bethany Thomas at (561) 741-2347.
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field