Application for Listing in the "Shop with a Conscience" Consumer Guide

Section 4: Retailer, Manufacturer, and Product Information
Retailer Name:
Mailing Address:
City:
State:
Zip:
Country:
Phone:
Fax:
E-mail:
Website:
Contact Name:
Contact Phone:
Contact E-mail:

Manufacturer Name:
Street Address:
City:
State:
Zip:
Country:
Phone:
Fax:
E-mail:
Website:
Contact Name:
Contact Phone:
Contact E-mail:

1. Please list and describe the product(s) to be promoted in the "Shop with a Conscience" Consumer Guide. Please note if any of the products are made with certified or non-certified organic and/or fair trade textiles or materials, as well as the name of the certifying body if applicable.


2. We strive to promote retailers that sell only sweatfree products. Please indicate what portion of the products the retailer sells is sweatfree according to the criteria in Section 1.
100% other %: Please explain if less than 100%:


3. Please provide a 40 word description of the retailer and products for the "Shop with a Conscience" Consumer Guide.


4. Indicate how shoppers can purchase the products, including website, phone number, and/or store front locations.


5. Mark whether you sell individual items, wholesale, or both. Individual sales Wholesale Minimum order: pieces
Section 5: Source of Products
Please provide information about each production facility that makes products that will be listed in the "Shop with a Conscience" Consumer Guide.
Production Facility Name:
Street Address:
City:
State:
Zip:
Country:
Phone:
Fax:
E-mail:
Website:
Contact Name:
Contact Phone:
Contact E-mail:
Languages in which the contact person is proficient:
Products listed in Section 3 that are made at this facility:
Section 6: Demonstration of Respect for Workers' Associational Rights
1. Do workers at the production facility presently belong to a democratic worker-controlled association? Yes No
Worker Association Name:
Street Address:
City:
State:
Zip:
Country:
Phone:
Fax:
E-mail:
Website:
Contact Name:
Contact Phone:
Contact E-mail:
Languages in which the contact person is proficient:
2. Is a collective bargaining agreement in force? Yes No
3. In the event that there is no democratic worker-controlled association at the production facility, management must demonstrate respect for the right to organize and bargain collectively by taking proactive steps to ensure that workers can freely exercise these rights without fear of retaliation. These steps shall include: a. Communicating to the workforce the factory's openness to workers' exercise of their associational rights, its commitment to refrain from any punitive action against workers for the exercise of their right to unionize and bargain, and its commitment to recognize and commence good faith negotiations with any duly constituted worker body, without unreasonable delay. b. Granting free access to the worksite for union representatives to carry out their organizing and representational functions without unreasonable restriction, and in the context of a formal neutrality or recognition agreement where a union so requests. c. Ensuring that there is no effort by management and/or supervisory employees, through word or action, coercive or otherwise, to influence any worker's decision about unionization or participation in union activities (with the exception of communicating the factory's openness to unionization and its commitment to abiding by the standards outlined herein). d. Fulfilling V management's commitment to grant recognition and to bargain in good faith. e. Permitting access to the factory to labor rights experts and representatives of NGOs and trade unions to conduct a program of worker rights education. If you answered "no" to question 6-1, an authorized representative of the production facility must commit to taking the steps listed above to guarantee workers' associational rights. After completing this application, you will be directed to a form which you should forward to the production facility for this purpose.
Section 7: Wages
Method of pay for non-supervisory workers is by:
Check all that apply: Piece Hour
How is the legal minimum wage guaranteed for piece rate workers?
The minimum base-pay for non-supervisory workers at the facility is per (hour, day, week, etc.) excluding benefits.
Full-time non-supervisory workers work an average number of hours: per day, per week, per month.
The pay-rate for overtime compensation is:
Other wage information:
Section 8: Additional comments:

Section 9: Posting and Notification Requirement
Within thirty (30) days of approval for listing in the "Shop with a Conscience" Consumer Guide, retailers must ensure that notices are posted in the relevant production facilities, informing workers that the products they make are listed in this guide because they are made in accordance with sweatfree criteria.
Section 10: Annual Renewal Requirement
Thirty (30) days prior to the date of the annual renewal of this information disclosure, the retailer will confirm or update information. In the event that any changes take place concerning the retailer's production facility, it is the responsibility of the retailer to update their information within thirty (30) days of the change(s).
Section 11: Verification of Information
I have answered the questions in this application completely and truthfully to the best of my knowledge.
Verify Date:
Verify Name:
Verify Title:
Verify Company: