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Please help us with our research by completing the form below. If you are reporting on a small business which does not have written policies or employee handbooks, please indicate so in the form, and eegl will contact you about our small business certificate program for businesses wishing to internally and/or publicly indicate LGBT friendly status.

Please complete the information below. Upon receiving your input, the organization you are submitting will be used in building a list of businesses and organizations with and without employee protections and benefits across
Western North Carolina.

	Name of Business/Organization
	Approx Number of Employees
	Address Line 1
	Address Line 2
	City
	State
	Zip Code
	Your Name
	Position/Job Title
	Email Address
	Phone Number
	Organization has a written anti-discrimination policy?	Yes No No, but interested in certificate program
	Policy Includes sexual orientaion?	Yes No
	Policy Includes gender identity?	Yes No
	Exact wording of policy
	Additional Comments

People for Employment Equality for Gays and Lesbians - eegl
P.O. Box 18640, Asheville, NC 28814
info@eegl.org